
Gass RV3 
Book . C 7 ? 



THE 



^a4/f_ 



i 



PRACTICE OF MEDICINE 
1.1 ON THOMSONIAN PRINCIPLES, 

ADAPTED AS WELL TO THE 

USE OF FAMILIES AS TO THAT OF THE PRACTITIONER* 

CONTAINING 

PROPOSITIONS ILLUSTRATIVE OF THE 

PHILOSOPHY OF THOMSONISM. 
A BRI£F eiSTORY 

OF THE SYMPTOMS. PECULIARITIES, AND GENERAL COURSE OF 
DISEASE IN ITS DIFFERENT FORMS AND VARIETIES ; 

WITH 

PRACTICAL DIRECTIONS FOR ADMINISTERING 

A THOMSONIAN COURSZi OF ay[EDICIN£, 

INCLUDING THE VARIOUS METHODS OF 
ADMINISTERING VAPOUR BATHS AND E3IETICS, 

AND 

ADAPTED TO THE WORK. 



BY J. W. COMFORT, M, D, 




PHILADELPHIA: 

PUBLISHED BY A. COMFORT, 295 MARKET ST. 

COAXES, PRINTER. 
1843. 



12 ^( "^ 



X>oo<>o<x>^>c^c>o<>c>cxx>=:xx>c<>cxxx>cx:x>o<x::>0'< 

Entered according to the Act of Congress, in the year 1843? 
by J. W. CoMFOKT, M. D.J in the Clerk's Office of the Eastern 
District of Pennsylvania. 

XX>CKX>--><>CXX>0<X::-<:'O<XX>0<X>C>C<XXXX>0<>0<X 



Q i I" 'C*--^ 



TO 



DR. SAMUEL THOMSON. 



THE 



PHILOSOPHER IN MEDICINE 



AND 



^©^HSS)iE 



OF THE 



THOMSONIAN SYSTEM OF MEDICAL PRACTICE, 



TMIiS WORK 



IS WITH DUB RESPECT INSCRIBED BY 



THE AUTHOR. 



TO THE READER. 



This work is prcvsented to tlie public as a Practical Guide in 
the treatment of disease, in accordance with the jyrinci'ples of 
medical science discovered and promulgated to the world by 
Samuel Thomson. 

The author does not claim to Iiave made improvements upon 
the fundamental principles of the Thomsonian system of practice. 
Daily observation affords confirmatory evidence that tliis system 
is based upon correct principles; and that the remedial means 
therein employed are adapted to the cure of every variety of 
disease that is curable by means of medical treatment. What 
1 have aimed at in tlie following pages, besides a description 
of the symptoms and peculiarities of the principal varieties of 
disease as detailed by medical authors, has been to point out 
that treatment best adapted to the different forms and stages of 
disease under various conditions of the system. ISJotwithstand- 
ing disease should be treated upon general principles, regardless 
of names, still there are varieties of it that demand more 
prompt and energetic treatment, than others in which the patient 
is apparently in a more dangerous condition. Thus in croup, 
for instance, an hours delay in a])plying the proper remedies 
may allow tlie disease to pass to an incurable stage. 

In the directions for treatment, repetitions have been intro- 
duced wiiich to some may appear superfluous. This course, 
however, was deemed necessary in a family work. 

The Thomsonian system based upon correct principles, needs 
not the garb of mifstery, often employed to conceal imperfection 
and to give to false knoxvledge the appearance of science. It is 
here before the community stripped of all disguise. The cause 
of tiie continuance of disease being resisted and overcome by vi- 
tal action, medical treatment to prove beneficial must harmo- 
nize with the principle of life. This is the corner stone prin- 
ciple of Thomsonism, the starting point and guiding line for 
directing the treatment in every variety of disease, in all its 
stages. 

Althoudi 1 have recommended some articles of medicine not 



TI TO THE READEKo 

cmpioyed in the Thomsonian practice generally, stili I amnat 
an advocate for enlarging the list of remedial agents beyoni 
what is necessary to fulfil important indications for the cur© 
of disease. Indeed the more the practice is simplified and re- 
stricted to the employment of general remedies the more success- 
ful will it prove. The medicines introduced to the notice of th© 
reader not recommended by Samuel Thomson, have been found 
beneficial for the purposes to which they are applied, and others 
contained in his materia medica of a less useful character have 
been excluded. 

Thomson's medical discoveries have as yet been illy appreci- 
ated by the majority of the people. The practice of medicine is 
viewed as a science requiring great depth of learning to compre- 
hend, and a knowledge of the anatomy of the humansystem ha& 
been thought necessary in order to know how to apply names to 
disease and to prescribe the proper remedies. A knowledge of 
anatomy though useful to the practitioner and indispensable t© 
the surgeoUf does not teach us the nature of the principle of life, 
nor afford the means of ascertaining the cause of disease, nor how- 
to apply the proper remedies. The human body is composed 
of a congeries of organs, each of which performs a specific func- 
tion, yet all these varied actions are sustained by the same mo- 
tive power or principle of life: and thus a pure stimulant, cay- 
enne pepper, for instance, that will support vital action in one 
form of disease, will have the same tendency in every other case» 
Finally, as a general rule, a medicine will have the same ten- 
dency in disease that it has upon the constitution when in health* 
It is by this touch stone that all remedial agents should be triedo 

J. W. C. 



Propositions or Premises which form the basis or first principles 

of the science of medicine I 

Health 7 

Disease f&. 

Of the general causes of disease ib. 

Reaction and fever 9 

PRACTICE OF MEDICIJ^E, 

CHAPTER I. 

Sect. I. Intermitting fever— Ague and fever IT 

11. Remitting, or bilious fever 23 

in. Typhus, congestive, and yellow fever -31. 





CHAPTER II. 






Eniptive Diseases, 




Sect. I. 


Small Pox 


41 


II. 


Vaccination— cow pox — kine pox 


49 


III. 


Varioloid— modified small pox 


53 


IV. 


Varicella— chicken pox— swine pox 


55 


V. 


Measles 


56 


VI. 


Scarlet fever 


59 


VII. 


Nettle=rash~Hives 


66 


YIII. 


Erysipelas— St. Anthony's fire— Rose 


67 


IX. 


Shingles 


70 


X. 


Scald Head 


72 


XI. 


Tetter 


73 


XII. 


Itch 


?6 


XIII. 


Ring worm 


77 


XIV. 


Chafing in children 


78 


XV. 


Prickly heat 

CHAPTER III. 

Disease affecting the Chest and Lung^. 


ib. 



Sect. I. Bronchitis 79 

II. Pulmonary consumption 85 

HI, Asthma, or phthisic 9S 

IV<, Summer catarrh, or cold — Hay fever 96 



till CO^^TEK'TS, 

V. Whooping cough 9f 

VI. Pleurisy 99 

VII. Catarrh — common colds 102 

CHAPTER IV. 

Diseases affecting the Mouth and Throat. 

Sect. I. Croup — Hives 10^ 

II. Quinsy 109 

III. Mumps 111 

IV. Common sore throat 112 
Ys Aphthous sore mouth — infant's sore mouth 113 

VI. Elongated uvula — falling of the palate 114 

CHAPTER V. 

Diseases affecting the Stomach and Bowels. 

Sect. I. Colic 115 

II. Cholera Morbus 117 

III. Cholera infantum — cholera of infants 119 

IV. Bilious colic 126 
V. Colica pictonum — painters' colic 128 

'VI. Dysentery 13l 

VII. Diarrh(Ea— Relax 135 

VIII. Veritomtis (^Injlammation of the Peritoneuni) 1ST 
IX. Constipation 140 

fX. Dyspepsia — indigestion 143 

XI. Worms in the stomach and bowels 151 

XII. Piles 155 

CHAPTER IV. 

Sect. I, Rheumatism 160 

II. Lumbago — rheumatism in the loin;? 169 

III. Gout ib. 

CHAPTER V« 

Sect. t. Inflammation of the kidneys 174 

II. Inflammafion of the bladder 178 

III. Diabetes — excessive flow of urine 182 

IV. Retention of urine 184 
V. Stranguary {Difficulty and pain in voiding urine) 188 

VI Incontineuceo? iw'me {Involuntary Jloiv of urine) 190 
VII. Suppression of urine (^The kidneys ceasing to 

form urine) 192 



CONTENTS* ^X 

CHAPTER yi. 

Disease of the Liver, 

Sect. I. Acute inflammation of the liver 194 

Chronic disease of the liver 196 

II. Jaundice 200 

CHAPTER VII. 



Sect. I. Apoplexy 203 

II. Paralysis — palsy 207 

III. Epilepsy {Convulsion fts— falling sickness) 214 

IV. Infantile convulsions 218 
V. Clilorosis — green sickness 220 

VI. Hysteria — hysteric fits 224 

VII. Fainting S29 
VIII. Hypochondriasis (^Dejection of mind — low spirits) 230 

IX. St. Vitus' dance 235 

X. Tetanus — locked jaw 240 
XI. Hydrophobia {Bite of a mad dog, or other rabid 

animal) 244 

XII. Neuralgia — Tic douloureux 248 

CHAPTER VIII. 

Sect. I, Dropsy 252 
CHAPTER IX. 

Sect. I. Scrofula 262 

II. Goitre 267 

CHAPTER X. 

Sect. I. Suspension of animation from drowning 270 
II. Suspension of animation from carbonic acid gas 271 

III. Suspended animation from lightning 273 

CHAPTER XI. 

Various forms of disease of the Eyes* 

Sect. I. Inflammation of the eyes from taking cold 274 

II. Rheumatic inflammation of the eyes 276 

III. Suppurative inflammation of the eyes 277 

IV. Scrofulous sore eyes 280 



CONTENTS. 

V. Blindness (^Total or partial) 284 

VI. Stye 285 

VII. Fistula lachrymalis (^Obstruction in the duct 

which conveys the tears from the eye into the 

nostril) 286 

CHAPTER XII. 



Sect. I. 


Insanity — mental derangement 


288 




1 Mania — general insanity 


290 




2 Partial insanity 


291 


II. 


Delirium tremens — mania a potu (Craziness 






from drinking) 


295 




CHAPTER XIII. 




Sect. I. 


Head-ache 


301 


II. 


Sick head-ache 


ib. 


III. 


Tooth-ache 


305 


IV. 


Ear-ache 


307 


V. 


Running of the ears 


308 


VI. 


Deafness 

CHAPTER XIV. 


SIO 



Sect. I. Palpitation of the heart 311 

II. Organic, or structural disease of the heart 315 

CHAPTER XV. 

Sect* I. Bleeding from the lungs 317 

II. Epistaxis (Bleeding from the nose^ 320 

III. Bleeding from wounds 322 

CHAPTER XVI. 

Sect. I. Cancer 3S5 

CHAPTER XVI. 

Sect. I. Inflammation 330 

II. Sprains 340 

III. Bruises 342 

IV. Severe bruises where the system receives a shock ib. 
V. Wounds of the scalp 346 

VI. Wounds produced by sharp instruments 350 

VII. Lacerated wounds 352 

VIIL Bruised wounds S5S 





CONTENTS. 


IX. 


Punctured wounds 


X. 


Wounds of joints 




Burns and scalds 


XL 


Chilblains 


XII. 


Treatment of frozen limbs 


XIII. 


Biles 


XIV. 


Carbuncle 


XY. 


Abscess of the female breast 


XYI. 


Whitlow or felon 


XVII. 


Hip disease 


XVIII. 


White swelling 


XIX. 


Ulcers 


XX. 


Simple or healthy ulcer 


XXI. 


Unhealthy ulcer 




CHAPTER XVII 




Venereal Disease, 



XI 

353 
S55 
356 
360 
361 
363 
364 
365 
366 
368 
37a 
374 
375 



Sect. I. Gonorrhoea 380 

Syphylitic sore, or chancre 384 

Bubo — swelling in the groin 387 

Secondary symptoms of syphilis 388 

CHAPTER XVIII. 

Sect. I. Obstructed Menstruation 390 

II. Treatment of fluor albus, or whites 392 

CHAPTER XIX. 

Miscellaneous. 

Bee-stings 393 

Nervousness — weak nerves 394 

Polypus of the nose 395 

Craaip in the legs and feet 396 

Prolapsus ani — protrusion of the bowel ib. 

Hernia, or rupture 397 

Strangulated hernia 398 

COURSE OF MEDICINE. 

General directions for administering a course of medicine 40£ 
Of the removal of morbid secretions, or false membrane 

from the coats of the stomach and bowels 411 

Blood-letting 412 

Steam or vapour bath 415 



Xll CONTENTS. 

Hot-air bath 422 

Partial steaming ib. 
Of the utility ot* emetics in the cure of disease in general 423 

Of the use of cathartics, or purgative medicines 431 

Injections or enemas 436 

Thonisonian Materia Medica 443 

Lobelia Inflata 443 

Preparations of lobelia 446 

Third preparation of lobelia 448 

Compound lobelia pills 449 

STIMULANTS 

Which raise and sustain vital action, and assist the efforts of na- 
ture to remove disease. 

Capsicum — Cayenne pepper 450 

Thomson's composition powder 454 

Ginger 455 

ASTRINGENTS AND DETERGENTS. 

Thomson^ s JVb. 3, or Medicine for Canker, 

Bay berry {Myrica Cirifera) 457 

Upland sumac {Rhus Glabrum') 458 

White pond lily (^JVymphia Odorata) 459 

Wild red raspberry (^Mnhiis Strigosis) ih. 

Witch hazle {Hamamelis Virginiana) ih, 

Evan root (^Guem Rivale) 460 

Marsh rosemary {Statia Limonium) ib. 

Dew berry (^Ruhus Procumhens) ib. 

Crow-foot — Cranes Bill (^Geranium Maculatum^ ■ 461 

Beach-drop (^Orbanche Virginiana) ib. 

TONICS— BITTERS. 

To strengthen the system and promote digestion. 

Peruvian bark {^Cinchona officinalis) 462 

Quinine 463 

White aspen and black aspen poplar (Fopulus Tremuloids^ 

and Fopulus Grandidentata) 464 

Balmony (Chelone Glabra) ib. 

Barberry {Berberis Vulgaris) ib. 

Golden seal (Hydrastis Canadensis) 465 

Virginia snake root {Serpentaria Virginiana) ib» 



CONTEiCTS-. Xlll 

Centuary (Chironia Angularis) 465 

Red dog- wood — Red willow (Cornus Cericea) 466 

Wild cherry {Prunus Virginiana) ib. 

Quassia i&. 

Tulip poplar (Liriodendron Tulipifera) 467 

Columba i&. 

Thoroughwort — Bonesett {Eupatorium Perfoliatum} ih. 

Chamomile (Jnthemis JSToUlis) ib. 

Myrrh ib. 

Thomson's No. 6, or rheumatic drops 469 

No. 5 syrup, or restorative cordial 470 

Unicorn {Helonias Dioicia) 471 

Bitter almonds, peach-meats and cherry stones ib. 

Spice bitters 472 

Ladies spice bitters ib. 

Conserve of hollyhock i&c 

NERVINES. 

To quiet restlessness, calm nervous agitation^ and promote sleep. 

American valerian (Cypripedium Humile, puhescenSf parvijlorum^ 

condi dum and spectabile) 473 

Scull-cap (SciUellaria Lateriflora) ib. 

Hops 474 



Carbonate of Ammonia 47 7 

Camphor ib. 

Oil of turpentine 478 

Oil of amber 479 

Oil of horsemint ib. 

Oil of peppermint 480 

Oil of anise seed ib. 

Oil of caraway ib 

VEGETABLE BALSAMS^ 

Balsam copaiva 480 

Balsam tolu 481 

Balsam fir ib<, 



Scabious (Erigeron Philadelphicum and E. Canadense) 482 

Pipsissewa {Pyrola Umbellata) ib 

# Q 



Cleavers 42g 

Burdock ij. 

Prickly ash {Zanthoxylum Fraxineum) 483 

Sarsaparilla i&, 

Guiacmn wood 484 

Worm wood 485 

Tansy ^, 

Slippery elm ( Ulmas Fidva) ib, 

ACIDS, 

Vinegar 486 

Lemon juice ib. 

Elixir of vitriol , 487" 

ALKALIES— ANTI-ACIDS. 

Super carbonate of vSoda 487 

Bi-carbonate of soda ib, 

Salseratus ib. 

Hickory ashes 488 

Charcoal ib. 

Lime water 489 

Prepared chalk 490 



Stimulating liniment 490 

'No. 3 pills 491 

Of cough mixtures ib, 

C'ough powder 492 

VOLATILE LOTIONS AND LINIMENTSo 

Granville's lotion 49£ 

Ammonia liniment 493 

Soap liniment ib. 

Camphor liniment ib. 



Simple cerate 493 

Basilicon ointment ib, 

Thomson's salve ib. 

Astringent ointment 494 

Pitch plaster ib^ 

Thomson's strengtliening plaster Ibo 



©ONTEITTS- XV 



Mustard plaster 




494 


Cayenne poultice 




495 


Eraolient and slightly stimulating poultices 


495 


Mallow's poultice 




ib. 


Catnip poultice 




ib. 


Charcoal poultice 




ib. 


Yeast poultice 




496 


Myrrh poultice 




ib. 


Gum Arabic 




ib. 


Arrow root 




49f 


Barley water 




ib. 


Milk porridge 




ib 


Oat meal gruel 




498 


Essence of beef, or beef tea 




ib. 


Chicken tea 




ib. 


Crust coffee 




ib. 


Panada 




ib. 


Mutton broth 




409 


Wine whey 




ib. 


Egg tea 




%b. 


Dryiqg roots and herbs 




%b. 


Brief remarks in relation to cleanliness, 


diet, &c» 


500 


POISONS. 







Means for counteracting the effects of concentrated acids 402 
Means for counteracting the effects of concentrated alkalies ib. 

Corrosive sublimate 502 

Arsenic 50S 

Antimony 504 

Lunar caustic 505 

Nitre— Saltpetre ib. 

Swamp sumac and poison vine ib. 

Opium 506 

Belladonna {Deadly Mghtshade) ib. 

Strychnia SOT 

Datura Strammonium (Gympson or JamesUwn We$d) ib. 



PROPOSITIONS OR PREMISES, 

WHICH PORM THE 

BASIS OR FIRST PRINCIPLES 

or THE 

SCIEJS*CE OF JIEDICIJ^E, 

AND ILLUSTRATIVE ALSO OF THE PHILOSOPHY OF THE 

THOMSONIAN PRACTICE. 



I. Matter, in all its diversity of character, quality, forni 
and combination, may be classed in two great divisions, namely: 
Organic and Inorganic matter, 

IL Organic Matter includes the two vast kingdoms of Na- 
ture; the Animal and the Vegetable kingdoms, 

III. Inorganic Matter includes all bodies not possessed of life, 
or such as are not endowed with a capacity Jor life, 

IV. Inorganic, hrute or dead matter, is controlled or go- 
verned by laws or forces, embracing chemistrij and natural phi- 
losophy, 

V. Organised or living bodies, though influenced to a cer- 
tain extent by tlie laws which govern inorganic matter, are 
sustained in their living state by -vital laws, '^ which hold supre- 
macy over and control those of physics and chemistry, which 
they modify and render subservient on many occasions to the 
purposes of vitality." 

VI. The principle of life is the same in all animated be- 
ings; and the human animal economy is governed by the same 
general laws. 

VII. Life, or the living state, is a series of actions or mo- 
tions in animal matter, of which organized bodies are alone 
susceptible. 

VIII. Without organization there cannot be life. And again, 
organized bodies, though possessed of a ^'capacity for life,'* 
require tiie aid of stimulants to call it into activity. 

IX. '*x\nimal life can be supported only by external stimu- 
lants.'' 

X. Life is produced by the influence of heat or caloric upon 
organized bodies. 

A 



XI. Heat, or caloric, is the power or agent by tvhicli other 
stimulants, as atmospheric air, light, electricity, galvanism, food, 
drink, and medicine, are made to act upon the system. 

XI I. Caloric brings into play that power {assumed to be 
an electro-galvanic injiuence) which is the immediate agent of 
those varied and complicated actions which forms and fashions 
the. organs; conveys to and approphiates nouhishment to 
every organ and tissue; ' ' sustains animal matter in a state of 
composition;^' selects and expels effete or worn out matter by the 
pores of the skin, the kidneys, and other depuratory organs; car- 
ries on all the various secretions; endows the organs with sensa-' 
tion; and enables them to react against, or resist the influences that 
tend to their destruction,'^ 

The two preceding propositions form the corner stone or hasis 
of the science of medicine. 

XIII. In the early period of animal life, until the organs 
become developed, heat is derived from tlie mother. As the 
organs become developed they are endowed with the power of 
producing or generating heat, and after birth the supply of ani- 
mal heat is dependent upon this function of calorification, or heat 
generating power. Thus vital action, first produced by heat, 
creates the power, or generates the influence necessary to the 
continuance of its actions. Heat is evolved in every part of 
the system, and the amount of caloric generated will be in pro- 
portion as vital action is greater. 

XIY. As the heat of the system is lessened, in proportion 
will vital action diminish. ^^ If the system be deprived of calo- 
ric for a certain length of time, all the preservative, recupera- 
tive, and sanative phenomena cease. It is the same also as re- 
spects oxygen.'' • 

XY. The stomach is the seat or " throne of tlie vital powers ;'^ 
the main centre or source from which is radiated the nervous 
power, wliich, by the aid of heat and oxygen, carries on and 
governs the important vital functions of circulation, respiration, 
digestion, nutrition, assimilation, and the various secretions. 

XVI. The stomach is in almost every instance the seat of 
disease. When this organ is disordered the power of gene- 
rating heat and nervous influence is diminished, and consequent- 
ly the actions and functions of other organs become weaivcned 
or deranged. In fever, although the heat of the surface is in- 
creased above the natural standard, yet the amount generated 
may be less than is produced in a state of health. The secre- 
tions and transpirations from the skin and mucous surface being 
suspended, the heat is locked up in the system, and this, it would 
seem, is a wise provision for retaining the heat, in order to sus- 
tain the recuperative actions, and thus effect a crisis in disease. 



Experiments liave sliown that in the most inflammatory disease, 
the hlood contains less positive electricity tlian it does when 
taken from ^ne in health. As the functions of the stomacli and 
bowels are restored to a healthy condition a natural warmth and 
action becomes established throughout the system. 

XVII. The same means that will restore the natural tem- 
perature of the system, as pure stimulants and the vapour bath, 
will also increase the electro-galvanic or nervous power, which 
governs the circulation and all the vital functions. 

XVIII. As the natural warmth of the system is reduced, 
either from a disordered stomach or from any other cause, the 
nervous power which maintains an equilibrium in the circu- 
lation is enfeebled; hence in disease a loss of the natural balance 
or equilibrium in the circulation of the blood is a common occur- 
rence. 

XIX. An undue accumulation of blood in a part is attended 
by a deficiency of it in other parts. Thus in fever there is an 
unnatural quantity of blood in the surface and a corresponding 
deficiency inwardly; determinations of blood to the head are 
accompanied with a loss of blood in the feet. 

XX. The same means that will correct a disordered stomach 
and '* raise tiie heat'^ of the system to its natural standard, 
will tend to restore the natural balance of the circulation of the 
blood. 

XXI. As the natural heat and nervous power is reduced, 
either from cold, disordered stomach, or from any other cause, 
the functions of digestion, nutrition and assimilation become 
enfeebled or disordered. The same cause also deranges the 
secreting organs, as the liver and glands of the mucous mem- 
branes. In many instances in disease the liver ceases to secrete 
bile; and the excessive thirst accompanying fever arises from 
diminished or suspended secretions of the glands of the mucous 
membranes. 

XXII. Whatever will cleanse the stomach, restore the na- 
tural heat and produce perspiration, will also tend to restore 
digestion, assimilation, the secretions, and in fine remove every 
derangement which occurs in the system. 

XXIII. The lower order of animals, as the hybernating 
species, will bear the abstraction of heat from their bodies 
without producing disorganization; they sink into a state of tor- 
por and insensibility during winter, and on the return of warm 
Tveather are reawakened into life and activity. 

XXIV. In the higher order of animals and in man, the 
abstraction of heat cannot be borne below a certain degree, 
but for a limited period, without producing disorganization and 
death. Hence they are endowed with a power to react against 
cold and other deleterious agents; and by thus establishing a 



counteracting force or influence, life and organiglion is pre* 
served against causes tending to their destrujjB^. Many of 
the symptoms which occur in disease, as paiiiallC^er, are 
caused by the recuperative, life-sustaining actions, the organs 
being driven, as it were, to a new mode of action, with the design 
of counteracting the influence of offending causes, and regaining 
their lost vitality. 

XXV. Fever does not constitute a disease, but is always 
an evidence of the existence of an offending cause in the system, 
and which nature is struggling to remove. 

XXVI. Living beings are ever surrounded by agents or 
powers which exert an influence in direct antagonism to the 
laws of life, tending to subvert or destroy vital action. Thus 
the living state is held, as it were, in a balance between oppos- 
ing powers. 

XXVII. The direct effect of cold and other morbific agents 
upon the system, is to weaken vital action, and to lessen the 
power of generating heat: hence disease of every form and 
variety commences with symptoms which show that the vital 
powers are weakened; these are lassitude, general debility, cold- 
ness of the surface and extremities, and chilliness. Cold and 
damp feet exert an influence in weakening and deranging the 
natural and healthy order of action in the system, and thus prove 
a fruitful source of disease. Dampness probably operates as a 
conducting medium by which tlie caloric, but more especially the 
electro-galvanic fluid escapes, not only from the lower extremi- 
ties, but also from the stomach and all the viscera of the abdo- 
men, by means of the nerves, which form a connecting chain of 
conductors or channels throughout the system, for the passage or 
circulation of this nervous fluid. As tlie nervous influence escapes 
from the system, the functions, over which it has control, become 
enfeebled and deranged. 

XXVIII. The first symptoms in disease prove a weakened 
condition of vital action. As the constitution reacts, a new 
train of symptoms ensues. The pulse becomes quicker and 
stronger; the surface becomes hot and dry, and the system is in 
a state of feverish excitement, or in other words, the patient has 
a fever. The constitution struggling against disease occasions 
the fever, and it is by this power of reaction that disease is over- 
come. 

Intermitting fever, as it is termed, commences with a chill. 
As the system reacts, fever comes on; and the recuperative efforts 
which occasion the fever, restore the heat, bring on perspiration 
and frequently other critical evacuations, more especially from 
the kidneys, by which the disease is partly or wholly removed, 
until the return of the succeeding chill, when the constitution in- 
stitutes the same preservative, recuperative train of action. In 



eruptive diseases, as small-pox, measles, and scarlet fever, tliere 
are always in th6 commencement general debility, chilliness, and 
a disordered stomach. These are the direct effects of the mor- 
bific agent that produces the disease, and but for a counteracting 
influence, vital actions would be overcome. The constitution 
establishes a reaction or fever^ by which the disease is thrown to 
the surface, producing an eruption on the skin. 

XXIX. The design of reaction or fever is to restore the 
lost heat and vitality, and remove all morbific or deleterious 
agents and their effects from the system, and thus preserve it 
from disease. 

XXX. A course of treatment that will cleanse the stomach 
and bowels and restore their natural action, and remove ob- 
structions from tlie system, will also remove fevers, by assist- 
ing to bring about what the fever is endeavouring to accomplish. 
When the offending cause is removed there will be nothing to 
excite fever or reaction. 

There is another and very opposite plan for subduing fever, to 
wdt: By reducing the vital forces or the recuperative efforts of 
nature, by bleeding, purging, and the use of poisonous agents, as 
nitre and antimony. This, thougli the fashionable practice, is 
nevertheless unnatural, unsuccessful, and hazardous to the future 
health, if not to the life of the patients on whom it is practised. 

XXXI. An important indication in the treatment of all acute 
diseases, attended with high arterial excitement or violent fever, 
is to overcome the contracted or spasmodic condition of the ca- 
pillary vessels by relaxing the system with lobelia. 

XXXII. To effect a relaxation of the system there is proba- 
bly no agent of equal value with the lobelia inflata. This me- 
dicine exerts a surprising influence in equalizing the nervous 
power, and in relaxing the system, without weakening the 
vital properties. In many instances, however, fever may be 
removed by the same means alone that will overcome a chill, to 
wit: pure stimulants and the vapour batli. Medical men of the 
old school, have not made a proper distinction between pure sti- 
mulants that strengthen and promote a healthy action, and those 
agents which occasion morbid excitement at the expense of the 
vital powers. Brandy and all alcoholic preparations aggravate 
fever, and hence it is inferred that all stimulants are improper 
in such cases. A patient, in a fever that would be injured by 
brandy, would in the same condition be benefitted by drinking^ 
freely of capsicum tea. It is as contra'ry to the theories of the 
regular practice, to use capsicum in scarlet fever as in any other 
form of fever, it being a disease of a highly inflammatory charac- 
ter, and yet a majority probably of the profession, make use of 
this article in scarlatina, and many of them depend exclusively 
upon it. 



XXXIII. As a consequence of a reduction and derangement 
of vital action, there are in disease tliickenedj mftrbid secretions, 
by Dr. Thomson termed ^^ canker," formed on the lining mem- 
brane of the stomach and bowels, and which in acute disease, as 
in dysentery, pleurisy, the various forms of eruptive disease 
and all other febrile affections, tend more or less to putrefaction, 
and thus prove deleterious to the constitution. The stomach be- 
coming coated with thickened tenacious secretion or "canker," 
is probably a general cause of a disease being protracted. It is 
an observation of Samuel Thomson, that " where there is a set- 
tled fever there is canker seated in the stomacli." The tongue 
is more or less coated with *^ canker" or morbid secretions in 
diseases, and its appearance affords a criterion by which to judge 
of the condition of the stomach. A tendency in this " canker" 
to soften and clean off from the edges of the tongue, is usually 
one of the first signs indicating a favourable crisis in a disease. 

XXXI Y. To remove the "' canker," (I make use of this term 
because it is the one generally employed and understood by Thom- 
sonians) is of the first importance in the cure of disease. This 
requires in the first place the use of such means as will excite the 
secretions, and "restore tlie inward heat," by which, as Dr. 
Thomson expresses it, the "canker is ripened," and as these 
morbid secretions soften they may be removed by the use of 
Thomson's '^No. 3," or " medicines for canker." The tannin 
and gallic acid contained in these vegetable preparations, have a 
strong affinity for the *' canker," and by combining with it over- 
come its tendency to putrefaction, and they also detach it from the 
coats of the stomach, and thus remove obstructions to tlie secre- 
tions, and enable nourishment to be taken up by the chyliferous 
vessels. 

XXXY. In violent local determination of blood to a part or 
organ, as in croup, inflammation of the brain, violent pleurisy, 
inflammation of the kidneys, apoplexy, &c. one of the most im- 
portant indications in the treatment is to overcome this undue 
determination to the diseased part by relaxing the system with 
lobelia, either by the stomach or administered by injection. The 
same course of treatment is applicable in profuse hemorrhage, as 
in bleeding from the lungs, nose, or uterine organs. 

XXXVI. Finally Dr. Thomson's "course of medicine" ful- 
fills all the important indications for the cure of disease in gene- 
ral; and, if judiciously applied, will effect a cure in all cases 
that are curable by means of medicine. 



HEALTH. 

Perfect health maybe defined to be that condition in which the 
principle of life, or vital power, holds supreme and undisturbed 
control over all the various actions in the body. 

DISEASE* 

Disease consists in a loss of vital power, or a weakened con- 
dition of the principle of life. 

Symptoms do not constitute disease. They are the immediate 
consequences of diminished vital power, or they may arise from 
the restoring efforts of the constitution. Thus the first symp- 
toms in disease, as languor and debility, coldness of the surface 
and chilliness, are the imniediate effects of a loss of vital power, 
whereas when reaction takes place, many of the accompanying 
symptoms, as fever, pain, inflammation, vomiting, diarrhoea, 
and convulsions, are the consequences of the recuperative efforts 
of the cqjistitution. 

Of the General Causes of Disease, 

Disease is produced by agents or powers which exert an in-^ 
fluence upon the system, not congenial to the vital 'principle, or 
which are not hi relation with, or adapted to, the laws of life. 

Exposure to cold and dampness; sudden vicissitudes of tem- 
perature; more especially when the system is in an exhausted 
condition; changes in the electric condition of the atmosphere; 
poisonous effluvia generated by the decomposition of vegetable 
matter; unwholesome food taken into the stomach; excesses in 
eating or drinking and in the indulgence of the sexual passions; 
and specific poisonous agents, such as produce small-pox, mea- 
sles and scarlet fever, are the general sources of disease. 

Cold and dampness are the most fruitful sources of disease. 
Tiieir direct effect upon the system is to weaken the vital power, 
and consequently diminish and subvert the healthy order of ac- 
tion in tlie system, and whatever organ or part of the body is 
weakest proportionabiy toits natural degree of vitality, that will 
be the part most likely to become diseased. Hence of any num- 
ber of persons exposed to cold and dampness, each may have a 
different form of disease. Thus one may have a pleurisy, ano- 
ther rheumatism, a third a simple catarrh, a fourth bronchitis, 
a fifth quinsy, a sixth neuralgia, a seventh sick head-ache, whilst 
another may be taken with bilious fever, and another with erysi- 



I 



8 

pelas. In this way almost every variety of disease may be 
brought on by the same cause. 

Exposure to sudden changes of tempei^ature, more especially 
from heat to cold when the system is exhausted from exercise, or 
the vital forces otherwise enfeebled may give rise also to a va- 
riety of forms of disease. 

A negatively electrified condition of the atmosphere has un- 
doubtedly an influence in lessening vital action, by abstracting a 
portion of the electricity from the system. It has been ascer- 
tained that a cloud highly charged with positive electricity, is 
surrounded by an atmosphere negatively electrified.^ Hence one 
who is subject to rheumatic affections, will have his pains in- 
creased on the approach of clouds, by the negatively electrified 
state of the air, but when the clouds are over his head, the pains 
subside by the atmosphere surrounding him being changed from 
a negative to a positively electrified condition. There are per- 
sons of peculiar temperament subject to certain forms of disease, 
as asthma and catarrh, during mid- summer only, occasioned pro- 
bably by a condition of the atmosphere which has the effect to 
lessen the amount of electricity in the body, or to derange its 
currents and thus pervert the healthy order of action in the sys- 
tem. That whilst it produces asthma in one it will occasion 
catarrh in another, dyspepsia in another, and in another rheu- 
matism. Many of the complaints peculiar to hot weather, as 
diarrhoea, dysentery and fevers, may occasionally arise> at least 
in part, from certain electric conditions of the air. 

Marsh miasmata,— Th^ poisonous effluvia, or vapour, arising 
from the decomposition of vegetable matter, together with cold 
and dampness, are believed to be the principal causes of the fe- 
vers that prevail during the latter part of summer and in autumn, 
more particularly in low marshy districts of country. It is cei"- 
tainly true that fevers prevail most in marshy places and neai* 
ponds of stagnant water. Newly cleared land evidently gives 
rise also to noxious vapours, from the decomposition that ensues 
on the exposure of the fresh earth to the sun. This will account 
for the prevalence of disease in newly settled places. 

The first effect of this miasmata upon the system is to weaken 
the vital powers; the strength becomes enfeebled; the appetite 
fails; there are languor, cliilliness and aching pains; precisely 
such symptoms as might be produced by exposure to cold and 
dampness. These symptoms are the direct consequences of the 

* Edward's on physical agents and electricity. 



9 

poisonous effluvia weakening vitality, and as the constitution ral= 
lies to expel the poison, fever is produced. 

The greater part of medicines employed in the regular prac- 
tice, have no relation to the laws of life, hut are repugnant to 
Nature, and injurious to the constitution. Such agents will mo- 
dify symptoms, or cliange the form of disease, hut often, where 
a cure is effected, it is the result of the sanative efforts of the con- 
stitution, in spite of medicine. 

Arsenic is often given in intermitting fever, and though it 
w'ill stop the chill and fever, it establishes a permanent disease 
in the mucous membrane of the stomacli and howels, and thus 
produces chronic dyspepsia, attended by a swollen abdomen, 
which is seldom removed under a year, and sometimes termi- 
nating in dropsical affections. 

REACTION AND FEVER. 

Reaction is the effort of the vital powers to overcome disease, 
or a method established by nature to remove from the system 
Avhatever is offensive or injurious. Hence most of the symptoms 
in acute disease are but the recuperative actions resisting the 
force of disease. 

In hybernating animals cold diminishes vital action in pro- 
portion to the loss of heat; tlie animal continues in a state of tor- 
por and insensibility until the return of warm weather, and then 
is reawakened into life and activity. The human organization 
though governed by the same vital principle, cannot bear a sus- 
pension of the vital action, or the temperature to be reduced be- 
low a certain degree, except for a short space of time, without 
endangering life, or producing disorganization of the parts in 
which the vital properties are sunk to a low grade. Hence, 
to preserve life against the threatening dangers \vhich beset it, 
the human system is endowed with a power of reaction; a method 
established by Nature to resist the influence of those agents 
which bear no relation to the laws of life, or which tend to 
destroy the vital principle. Fever and reaction in excess, are,'* 
says professor Jackson, '* precisely the same; they are properly 
symptoms rather than disease; they are salutary and sanative in 
design: they are the evidences of power and force which admit 
of remediate and curative operations; and they are in themselves 
the recuperative processes of the economy in action, instituted 
for its preservation.'' Therefore the ** design of nature in dis- 
ease should be studied and aided.'^ 

Dr. Samuel Thomson in his "remarks on fevers'' says-^ 
^* What is commonlv called fever, is the effect and not the cause 

B 



10 

of disease. It is the struggle of nature to throw ofi' disease. 
The cold causes an ohstruction, and fever arises to remove it. 
This is universally the case. Remove the cause and the effect 
will cease.^' 

This theory of fever advanced hy Dr. Thomson, and doubt- 
less original with him, was maintained by Sylvius and others 
of the early writers on medicine. But tlie failure of their prac- 
tice arose from the employment of remedies Avhich tended to ag- 
gravate rather than assist the efforts of nature. The medical 
faculty have never made the proper distinction between pure sti- 
mulants, which raise and support vital action, and those which 
provoke an unnatural action, and ultimately exhaust the strength. 
It is to Samuel Thomson we are indebted for the discovery and 
selection of medicines which harmonize with the laws of life, and 
if judiciously applied are adapted to every variety of disease. 

"Again," says Dr. Thomson, ^^ there is no other difference 
in all cases of fever, than what is caused by the different degrees 
of cold, or loss of inward heat, which (meaning cold and heat) 
are two adverse parties in one body contending for power. If 
the heat gains the victory, the cold will be disinherited, and 
health will be restored; but on the other hand, if cold gains the 
ascendency, heat will be dispossessed of its empire, and death 
will follow of course.'' ^ # -)(= ^ # " When the power of 
cold is nearly equal to that of heat, tlie fever or strife between 
the two parties may continue, and occasion what is called a con- 
tinued fever. In ague and fever, the strife between the cold and 
heat occurs periodically, in some instances, every day, in others 
every second, and sometimes every third day." "In attempting 
to cure a case of this kind," says Thomson, " we must consider 
whether the fever is a friend or an enemy; if it is a friend, which 
I hold to be the fact, it should be aided by increasing the power 
of heat internally, and thus assist in driving out the cold, and 
life will bear rule." In alluding to tlie practice of regular phy- 
sicians in fever, Thomson says, ^^ Instead of following the dic- 
tates of nature and aiding to subdue the cold, the doctor uses all 
his skill to kill the fever." ^ # ^}^ # *< Support the fever 
and it will return inside w here the heat belongs; the cold which 
causes the disease will be driven out, and health will be restored. 
In all cases of fever the cause is the same in a greater or less 
degree, and requires one general plan of treatment. Cold causes 
canker (a morbid secretion) in the stomach and bowels, and be- 
fore the canker becomes seated^ the hot medicine alone, assisted 
by the vapour bath, will throw it off. When the fever becomes 
settled, or continues to return, it is evidence of seated canker in 
the stomach and bowels. If the inward heat is kept up, the 



11 

canker will ripen and come off, and then there will be no more 
fever." *^This idea is new," says Dr. Thomson, *'and was 
not known until my discovery." 

*< When a patient is bled," says Dr. Thomson, *Mt lessens 
the heat and gives double power to the cold; like taking out of 
one side of the scale and putting it into the other, which dou- 
bles the weight, and turns the scale in favour of the disease. By 
giving opium the feelings are deadened; the use of antimony, 
calomel and nitre, tends to destroy what heat remains, or more 
properly destroys the power in the system of producing heat, 
and plants new crops of canker, which will stand in different 
stages in the body, the same as corn planted every week will 
keep some in all stages of its growth; so are the different de- 
grees of canker. Tiiis is the reason why there are so many dif- 
ferent fevers as are named; when one fever turns another sets in 
and so continues, until the canker is all ripe, if the season is long 
enough; if not the cold and its effects take them off — then it is 
said they died of a fever. It might with as much propriety be 
said that the corn killed with frost died with the heat." * ^ 
"When a person is taken sick it is common to say, I have got a 
cold, and fear I shall have a fever; but no fears are expressed 
about the cold lie has taken; neither is it mentioned when the 
cold left him. The fashionable practice when the fever rises is 
to destroy the heat, and the same means which they often use to 
cure the sick, would destroy the health of a well person. How 
much more reasonable it is when the fever rises to help it to 
throw off the cold which caused the disease." 

There are continued currents of ^' elec.tro-galvanic" or nerv- 
ous fluid passing from the great centres of the system where it 
is generated, to the surface of the body, and also returning cur- 
rents from the surface inwardly. It is by these currents of 
nervous power that the circulation is attracted to the surface, 
and the venous blood returned to the heart. The force of the 
heart's contraction would be altogetlier inadequate to propel the 
blood to the surface against the immense pressure of the atmos- 
phere. Thus during the cold stage of intermittent fever the 
heat and nervous power are diminished, the blood recedes from 
the surface, and being collected in the internal organs, gives 
rise to the generation of nervous jiuid^ which being radiated 
through the nerves to the surface, attracts the blood to the skin, 
and thus reaction or fever is produced. To sustain the power of 
generating heat and nervous fluid by pure stimulants, will assist 
the fever in bringing on a crisis by perspiration, urine, &c. and 
then the fever subsides. 



12 

The means recommencled by Dr. Thomson for "raising the 
heat of the system" and for ^M^eeping the inward above the out- 
ward heat," are the same that are required to sustain the gene- 
ration of the nervous power, and the regulating of its currents 
outwardly and inwardly, and thus tend to maintain a proper 
balance in the circulation of the blood. 

In tracing the progress of fever we find it terminating in a 
restoration of the seci-etions, and by establishing some critical 
evacuation, more particularly by sweat and urine. This fact 
surely points out the design of nature in establishing fever or 
reaction. Thus in every case of acute disease which terminates 
favourably, we find a general warm perspiration, and an increased 
secretion of urine depositing a brick dust sediment, constituting 
almost invariably the more prominent crisis symptoms. The 
plan of treatment established by Dr. Thomson will assist the 
constitutional efforts in bringing about a crisis in disease, and 
without in the least degree aggravating the fever, but on the 
contrary will at the same time that it aids its efforts, generally 
moderate the violence of its symptoms. But take a case of re- 
mitting fever where the symptoms are all favourable, bleed this 
patient every day, purge with active cathartics, give him ice 
water to drink, and pursue this course for a week, and in nine 
cases out of ten the fever will at the end of this time assume a 
malignant type, but which would have formed a crisis and the 
patient been convalescent if not interfered with. 

ft is by reaction that the organization is sustained against all 
debilitating causes. Thus if a person in health be bled to faint- 
ing, reaction will follow, and the system may be brought into 
the same excited condition for which blood-letting is frequently 
employed; and the subsequent disturbance in the system will 
generally be greater in proportion as the vital powers are de- 
pressed by the loss of blood, 1 have heard Dr. Parrish relate a 
case of a man who had been for a length of time subject to frequent 
losses of blood from piles, and subsequently underwent an oper- 
ation, by which he lost a large quantity of blood. This, a few 
days after the operation, thi-ew the system into a state of tumult- 
uous excitement, the face red, eyes s])arkrn]g, with a full bound 
ing pulse, and the carotid aileries throbbing very strongly, and, 
as the d(>ct(>r stated, the patient exldbitcd symptoms, which every 
surgeon would have said demanded bleeding, when at the same 
time the patient uas drained of almost all his blood, and the con- 
stitution was struggling against the effects of its loss. Not many 
iTsonths since, one of the ])!»ysicians to the Blockley Hospital, a 
man of extensive experience, iKiving been fourteen years in prac- 
tice^ on examisiing a patient in one of the wards, asked of one 



of the house physicians why that patient had not been bled, and 
immediately directed a pint of blood to be drawn. The doctor 
was informed, however, that this patient had a surgical opera- 
tion performed a few days previous, and that secondary hemorr- 
hage had taken place, and the patient had been already nearly 
bled to death. 

Dr. Dunglison in a lecture mentioned the case of a patient in 
the hospital w ho was at sea a length of time without solid food, 
and labouring under great excitement, the doctor ordered him 
to be bled, but found that the blood was impoverished and almost 
deprived of its red globules, and that a different course of treat- 
ment was necessary, that the excited state of the nervous system 
arose from this impoverished state of the blood, requiring stimu- 
lants and generous diet. 

A frequent abstraction of blood will produce a determination 
to the brain, and the arterial system be thrown into a state of 
great excitem.ent, presenting the same symptoms, which accord- 
ing to the doctrines of the schools of medicine, require the use 
of the lancet; the loss of blood being at the same time the sole 
cause of the excitement; the constitution reacting against the 
morbid effects of the loss of blood. How often does inflamma- 
tion of the brain ensue in remitting fever, and tlie disease be- 
come of a malignant character, probably in nine cases out of ten 
produced either by bleeding or purging, or by both; reducing 
the vitality so low that nature is driven to rally all her powers 
to ** save a wrec/c.-" the clashing forces struggle for the ascend- 
ency w hich too often is decided in favour of the foe to life, aided 
probably by the college skill of the doctor, who errs, yet unde- 
signedly. Excessive loss of blood is not always followed how- 
ever by .reaction; in some instances the system remains in a state 
of debility, accompanied by some clironic disorder, as dyspepsia, 
liver complaint, consumption, dropsy, &c. 

The doctrine tliat fever is disease^ has given rise to the plan 
of treatment adopted by the regularly educated physicians. They 
aim to subdue vital force, considering the fever as an exalted 
condition of vital action and which requires to be reduced by 
sedative agents, which tend to destroy the vital principle; as 
niter, antimony, neutral salts, &c. together with blood-letting. 
This plan of treatment though sustained by the authority of 
great names, and by law and fashion, will probably be viewed 
by future generations as Iiaving been fraught with glaring incon- 
sistency, and which must necessarily have been att<^iided with 
disastrous consequences. Such, however, is tlie force of educa- 
tion that great minds may imbibe errors which are easily seen 



t 



14 

and detected by the unscientific. A patient may be brought to 
'Meatlrs door" by the treatment instituted to cure him, and be 
kept ill for months, and at the same time the physician get great 
praise for his skill; the known liability to be ill from other 
causes, renders it difficult to determine as to the effects of the 
treatment. If the regular practice however was subjected to th« 
same degree of rigid scrutiny as has been the practice of Samuel 
Thomson, and with the same prejudices to encounter, it would 
doubtless soon be abandoned, provided tlie general results of the 
Thomsonian practice were brought fairly before tlie community. 

The cause of disease may be so powerful that the reaction or 
fever cannot accomplish its design of establishing some critical 
evacuation, the vital powers being exhausted in the struggle^ 
Thus yellow fever has been defined by Dr. Whytt, of Edinburg, 
" That fever which continues two or three days, and then termi- 
nates without any critical discharge, by sweat, urine, or stool, 
Sec. leaving the patient excessively week, with a small pulse, 
easily depressible by any little motion, or by an erect posture; 
and which is soon succeeded by a jaundice colour in the whites 
of the eyes and skin, vomiting, hemorrhage, &c. without any 
fever. 

In that form of disease called typhus fever, the principle of 
life, is reduced below the point of healthy or efficient reaction; 
the power of the cause of disease prostrating the energies of life, 
and the reaction assumes a low malignant grade of fever. Re- 
mitting fever is sometimes converted into typhus fever, by 
blood-letting and purging, or from exposure to cold and damp- 
ness; food taken into the stomach which it cannot digest, has in 
frequent instances caused a fever to assume a malignant charac- 
ter, for as the action of the stomach is lost, or its energies op- 
pressed, the vital powers sink accordingly. 

Fever being the "friend," it may be asked, is a violent fever 
more favourable than one that is of a milder cliaracter? To this 
it may be replied. If the cause of disease he powerful, the reac- 
tion will require to he proportionally strong to oppose its ivfiuence^ 
and therefore under circumstances requiring it, a high fever is 
more favourable. 

If the vital powers he too feeble to estahlish an efficient reaction 
against a powerful cause, the fever will vx)t be of a mild, hut of a 
low malignant or typhus g7^ade. 

If the cause of disease he weak, and the vital energies strong, the 



15 

fever will be of a mild character, and soon form a crisis, as in 
ordinary chill and fever. 

Though the force of disease may he weak and the general health 
much impaired, the fever may partake of a malignant character. 

Where the force of disease is powerful and the vital powers 
are in a depressed condition, the reaction may commence with a 
violent tumultuous excitement or fever, but these symptoms will 
be soon followed by great prostration and sinking of the vital 

forces. 

The recuperative or restorative design of fever is manifest 
in the eruptive diseases, as small-pox, scarlatina and measles. 
Beginning with a disordered stomach, which is the seat of the 
disease, the constitution reacts with the design of throwing the 
disease to the surface, and when this is accomplished, tlie dis- 
tress of the stomach is relieved. Patients have died of these 
diseases without the eruption appearing; the violence of the 
cause of disease prostrating the nervous energy, and suspending 
the function of calorification; the patient remaining cold and 
stupified as if stunned by a blow, or if there be fever it will be of 
a low typhoid character. In all such cases prompt measures 
should be instituted, in order to excite reaction, the only way by 
which the disease can be expelled. The plan recommended by 
Dr. Thomson is to lighten the air around the patient by the 
judicious application of warmth and moisture, and to give the 
most active stimulants, as the third preparation of lobelia, with 
a view to rouse the stomach from its state of torpor, and to evac- 
uate its foul contents, which in most instances occasions its op. 
pression, and the consequent depression of the nervous energy. 
There are no means so efficient in bringing on reaction, as an 
emetic of the third preparation of lobelia and the application of 
warm vapour around the patient. 

Had those earlier writers and teachers of medicine who pro- 
proclaimed doctrines similar to those of Samuel Thomson in re- 
lation to fever, been fortunate enough to have discovered the 
proper means of assisting the efforts of nature, instead of resort- 
ing to the use of wine, brandy and other alcoholic preparations 
as stimulants, the practice of medicine would long since have 
been established upon a firm and unchangeable basis. But the 
injurious effects arising from the employment of such stimulants, 
induced them to change the theory, although nature proclaimed 
its truth in language too plain to be misunderstood. Hence for 
the want of a knowledge of the proper means to effect the indi- 
cations which this theory pointed out, namely- to assist *N*ature, 



16 

the doctrines and practice of medicine have heen as change-* 
able as the fashions in dress. *' The history of practical medi- 
cine," says Dr. Eberle, " consists of little else than a review 
of the various doctrines which have successively risen and sunk 
again concerning the nature and treatment oi fever,'' 

A great man advances a theory of medicine and the practice 
must conform to it. Thus Broiissais when he exposed the errors 
of the prevailing doctrines in medicine, advanced the theory that 
all acute diseases arose from irritation in the mucous membrane 
of the stomach and bowels, and confined his remedies principally 
to leeches and gum water; denied his patients every kind of sti- 
mulant, because, as he supposed, every stimulant would increase 
the irritation. The announcement of the doctrines of Broussais 
influenced to a certain extent the practice of many physicians at 
one time in this country. A profesfeor in the University of 
Pennsylvania commenced publishing a work on the *^ Principles 
of Medicine," but before the second volume was ready for the 
press, the doctrines of medicine became so changed, that the fur- 
ther publication of the work was suppressed. 

The first principles of medicine once established, and the pro- 
per means and remedies discovered for fulfilling the general in- 
dications of treatment, the practice of medicine must be simple, 
plain, and unchanging. 



PRACTICE OF MEDICINE- 



CHAPTER I. 



SECTION I. 



INTERMITTING FEVER— AGUE AND FEVER* 

The general causes of tSlgue — Noxious or poisonous vapours in 
the air, called Malaria or Marsh Miasmata, arising from the de- 
cay and decomposition of vegetable matter in marshes, and from 
grounds inundated and then drained — The drying of mud from 
ponds that have been drained, the decomposition of vegetables, 
as flax, hemp and potatoes. Newly cleared land is supposed to 
give rise to deleterious exhalations from the decomposition pro- 
duced by the exposure of the fresh earth to the sun. Cold and 
dampness are frequently the exciting cause of the disease. 

The same cause or combination of causes that produce ague in 
one may cause dysentery in another, jaundice in another, and in 
another neuralgia. 

A person of vigorous constitution and in good health will best 
bear exposure to marsh miasmata without being effected by it. ^ 

Symptoms and general course of Intermitting Fever, — The first 
symptoms presented in this form of disease are such as occur in 
the initial or forming stage of every variety of disease attended 
with fever, namely: general debility, loss of appetite, more or 
less distress at the pit of the stomach, obstructed perspiration, 
restlessness and languor, aching in the back and limbs, and in- 
creased sensibility to cold. 

The cold stage or cAiZL— The chill comes on with creeps along 
the back, and an irresistible desire to yawn and stretch. There 
is a general coldness and contracted state of the skin, presenting 
that rough appearance called goose-flesh, and a sensation down 
the back as from trickling of cold water; the mind is confused 
and dejected, the pulse is small, contracted, frequent and firm. 
The jaws begin to quiver or chatter, and a general shivering 

C 



18 INTERMITTING FEVEE. 

takes place over the whole body; sometimes these rigors are so 
"violent as to shake not only the bed, but even the floor and par- 
tition. The breathing is hurried, and sometimes accompanied 
with a hacking cough, and a feeling of stricture across the breast. 
Vomiting is not an unusual occurrence, more particularly about 
the termination of the chill. The secretions of the mouth are 
suspended occasioning urgent thirst. The urine in this stage 
" is clear, colourless, without sediment, and often copious." 
The chill in some instances continues but a few minutes, and in 
others for several hours. Sooner or later reaction commences, 
and the patient experiences flashes of heat through the body, 
which increase until the chill is entirely gone and the fever be* 
comes fully developed; distressing vomiting often occurs at this 
period. 

T^ie reaction or hot stage. — The blood which during the chill 
was confined to the internal organs and vessels, when reaction 
takes place is attracted to the surface: the countenance becomes 
flushed and the skin dry and hot; the pulse rises and becomes full 
and strong; the mind becomes more active, with a rapid flow of 
ideas; there is pain in the head, back and extremities, and not 
unfrequently more or less delirium, or as it is commonly express- 
ed the patient is " light-headed.-' The urine is scanty, and 
high coloured, but without sediment. The duration of the fever 
varies in different cases, but finally effects a crisis by a restora- 
tion of the secretions from the skin and kidneys, and thus termi*- 
nating in 

The sweating stage or crisis. — As perspiration takes place the 
breathing becomes less difficult; the pulse softens, and a general 
abatement of all the distressing symptoms takes place as the per- 
spiration becomes general and free. The urine is high coloured 
and deposits a reddish sediment on standing. As the sweating 
continues the symptoms of disease continue to lessen until finally 
the patient is apparently free of disease. 

These stages, viz : the cold, the hot and the sweating stage, 
form what is termed a paroocysm of intermitting fever. These 
paroxysms occur periodically, either every day, every other day, 
or once in three days, and generally about the same hour of the 
day. 

During the intermission or interval between the paroxysms, 
the patient will in some instances be entirely free from all un- 
pleasant symptoms, except debility; more frequently, however, 
the patient experiences a considerable degree of indisposition, 
with loss of appetite, costive bowels, furred tongue, and mucFi 
weakness. 

Intermitting fever, like every other form of disease, is subject 



AGUE AND PETER. 19 

to various modifications, depending upon the circumstances un- 
der which the disease occurs, in relation to the condition of the 
patient, and various other causes which may tend to modify dis- 
ease. Thus, if the disease is connected with a torpid state of the 
liver, the skin and whites of the eyes will he yellow, and it will 
be said the patient is bilious^ or that he has a '^ bilious intermit- 
tent 

When the disease attacks persons of shattered and exhausted 
constitution, the efforts of nature or the vital powers may he too 
feeble to establish an efficient reaction, forming what is called 
congestive intermittent. Tlie cold stage will be unusually long, 
with stupor and deep seated pain in the head; vertigo, faintness 
and great oppression across the chest. The fever will be very 
slow in coming on, the skin being scarcely warm, and the patient 
will continue greatly oppressed, with a pale countenance and 
great oppression and anxiety of breathing; the pulse will be 
small, quick, and tense, and a distressed and burning sensation 
inwardly. 

Autumnal intermittents are apt to be connected with extensive 
derangement of the stomach, liver, and bowels, designated by 
writers as gastric inter^mittents. 

Signs which distinguish ag^ie and fever from hectic fever. 

I. In hectic fever there is an absence of the distress in the back 
and limbs, which attends a paroxysm of intermittent fever. 

II. Hectic fever occurs at irregular periods. 

III. In hectic fever the hot stage is attended with a circum- 
scribed flash on one or both cheeivs ; without pain in the head 
which is a most distressing symptom in ague. 

IV. The pulse in hectic fever instead of being moderated by 
the subsidence of the paroxysm remains quick. 

V. The tongue which is furred in ague is clean and smooth in 
hectic. 

VI. In hectic fever the urine is muddy during the paroxysm, 
and clear after. In ague it is muddy or turbid after a pa-^ 
roxysm. 

VII. The mind is full of hope and confidence in hectic and 
desponding in intermittent fever. 

Intermitting fever very seldom proves fatal except where it 



so INTERMITTING FEVER. 

occurs in brokendown constitutions, or when complicated with 
extensive derangement of some important organ. In low marshy 
districts of country the disease is apt to become chronic, from the 
continued exposure to the cause; the countenance is sallow, the 
abdomen distended and the spirits sunken and dejected. 

Favourable signs. Each succeeding paroxysm occurring at a 
later period, scabby eruptions about the mouth and nostrils, 
cleaning of the tongue and restoration of the natural secretions 
of the skin and mucous membranes, and an improvement in the 
appetite; indicate a favourable termination of the disease. 

It frequently happens that an unusually severe paroxysm, 
without there being any assignable cause, terminates the disease, 
the patient becoming convalescent. 

Intermittent fever has its seat in the stomach and bowels, and 
subsequently other organs become affected, more especially the 
liver. An inactive torpid liver is doubtless a frequent cause of 
the disease becoming chronic. In such cases the skin and whites 
of the eyes become sallow, the abdomen swollen and the spirits 
sunken and dejected, and the disease proving difficult of cure. 

Treatment — The indications of treatment are to cleanse the 
stomach and bowels, together with other means for aiding nature 
in her efforts to expel the disease. 

Thomson^ s course of medicine — By its prompt action upon the 
stomach, bowels and skin, and by the fresli impulse given to the 
circulation and the secretions, will prove the most effectual me- 
thod of curing intermitting and all other varieties of fever. A 
very effectual plan is to commence with a course of medicine an 
hour or two before the time at which the chill comes on. In or- 
dinary cases where the paroxysms occur every other day the 
course of medicine will seldom require to be repeated more than 
two or three times to effect a cure, provided a proper intermedi- 
ate course of treatment is pursued. 

Treatment during the paroxysm, — 1st. Of the cold stage, — 
During the chill the patient should drink hot teas, as composi- 
tion, cayenne, or pennyroyal, and be covered warm in bed, and 
hot bricks or jugs of hot water placed at the feet and back, and 
third preparation of lobelia, tincture of capsicum, or some stimu- 
lating liniment rubbed along the spine. This will assist to bring 
on reaction and overcome the chill. 

Where the vital powers are in an exhausted condition, and 
insufficient to establish reaction, constituting what is termed con- 
gestive intermittent^ an emetic of the third preparation of lobelia 
should be given to relieve the stomach of its foul contents and to 



AGUE AND FEVEB. 2l 

arouse its sunken energies; and external warmth applied around 
the patient. After free vomiting the system will generally react, 
but if it should not the medicine must be continued, and the 
same administered by injection to the bowels, together with mus- 
tard plasters to the stomach, wrists and ankles. In some rare 
cases fatal congestion has taken place during the cold stage, for 
want of power in the system to produce reaction. 

Treatment during the hot stage, — "When the fever comes on all 
dry heat may be removed from around the patient, but the hot 
medicine will be proper with a view to aid the reaction to bring 
on a crisis by perspiration. \Yhere the fever is of a violent cha- 
racter and the patient greatly distressed, an emetic should be 
given, and the patient kept relaxed hj broken doses of lobelia, 
given either alone or in the stimulating teas, and bathe the sur- 
face with whiskey, vinegar, salseratus water or simple water. 
Where the thirst is urgent, the patient craving cold drinks, they 
may be allowed him in small quantities. A draught of cold wa- 
ter will in some instances cause perspiration in the latter period 
of the hot stage. Acidulated drinks, as lemonade, are very 
grateful to patients, and may be taken in moderate quantitieso 
The thirst however arising from suspended secretion of the mu- 
cous membrane of the mouth and throat will be more effectually 
relieved by capsicum tea than by cold drinks. Simple herb teas, 
as mint, pennyroyal and balm, are proper in any stage of the 
disease. Bathing the surface with spirits or vinegar when the 
fever is violent affords relief to the patient. Hot bricks wrapped 
in cloths wet with vinegar, will in some instances afford relief 
even during the fever. 

When the sweating stage comes on, all cold drinks are inad- 
missable. The patient should keep in bed and take hot medicine 
to favor and continuine the perspiration. When the perspi- 
ration ceases the body and limbs should be bathed with Thom- 
son's No. 6, and dry warm clothing put on. 

Treatment during the intermission* — The treatment during the 
interval between the paroxysms is to be regulated according to 
the circumstances of the case, and the condition of the patient. 
Thus in the first stage of the disease pure stimulants, as cayenne 
and composition, should be used with a view of sustaining the 
strength and aid in restoring the secretions. The compound lo- 
belia pills answer the place of the teas, two or three of which 
may be taken every three or four hours. 

Indications for the use of tonics, — When there is a complete in- 
termission of fever between the paroxysms, and the tongue be- 



£2 INTERMITTING FEVER. 

gins to clean, and assume a more natural appearance, tonics wiH 
come in play. 

Peruvian bark. — This is probably the most effectual tonic in 
intermitting fever, and given at a proper time, or under certain 
conditions of the system, no bad consequences probably would 
ever arise from its use, even in large doses. 

The advocates of Homeopathy in proof of their theory, assert 
that Peruvian bark continued to be taken by a person in health 
will produce a disease resembling intermitting fever. In certaia 
conditions of the stomach, for instance where there is a redun- 
dancy of acid or the secretions otherwise deranged, Peruvian 
bark or other astringents, as hemlock and marsh rosemary, may 
produce a sense of oppression and constriction at the stomach, 
and even occasion intermitting fever. Peruvian bark however 
will not disorder a healthy stomach, nor wdll it produce inter- 
mitting fever, except under peculiar circumstances. 

In preparing Peruvian bark I usually combine it with a por- 
tion of Virginia snake root and orange peel, or with spice bitters, 
and give in the form of a decoction. It may also be prepared 
in tincture, or taken in good wine as Madeira, or sherry. Pre° 
pared in wine it should be taken just before or after meals. 

Quinine pills, — Pills composed of equal parts of quinine and 
capsicum, form a substitute for barks and all other tonics; and 
on account of the facility with which the pills are taken, they 
are generally preferred to any other preparation. Quinine con- 
tains the active principle of the Peruvian bark. I cannot dis- 
cover any objection to its use in a proper state of the stomach, 
A few hours before the period at wiiich the chill comes on, the 
quinine or whatever tonic is used, should be given freely; when 
the patient is taking quinine, it will be proper to omit the use of 
bayberry and all other vegetable astringents. 

A great variety of tonics have been employed for ague, wliich 
answer in many cases equally as well probably as the Peruvian 
bark and its preparations, sucli as Thomson's No. 4 bitters, vari- 
ous species of the poplar and willow, the broad-leafed dog wood 
bark, wild cherry bark, columbo, gentian, quassia, Virginia 
snake root, and thoroughwort or bonesett. 

Before resorting to the use of tonics attention must be paid, as 
before mentioned, to the condition of the stomach, and not employ 
them whilst the tongue is dry and exhibits no tendency to clean 
at the edges. Neither should they be used so long as there is a 
feverish condition during the interval between the paroxysms. 

Relapses are liable to occur if tlie patient be exposed to t]ie ex- 
citing cause. 



BfeMlTlTlNG OR BllilOtJS FEVEfi. S3 

Precautions* — Avoid cold and dampness; dress warm, and 
never go out in the morning or evening with an empty stomach. 
If the patient resides in a marshy district he should continue the 
use of tonics in order to invigorate the system. 

The cold shower bath may also be used as a preventive, where 
there is no particular organic disease, as an enlargement of the 
spleen or liver. 

The plan adopted by some practitioners and which generally 
proves successful in preventing a relapse, is to give the patient 
for instance half an ounce of Peruvian bark or eight or ten qui- 
nine pills, ahout the sixth day after the last chill, and then at the 
end of the next six days give a less quantity, and in this way 
continue giving the tonic, every sixth day lessening the quantity 
each time. 

If there are symptoms indicating a return of the disease, the 
patient should go to bed, cover warm and take freely of compo- 
sition or of capsicum tea, or what is better go through a course 
of medicine. 



SECTION II. 



UEMITTING OR BILIOUS FEVER. 

A continuance of the fever to a greater or less degree during 
the interval between the paroxysms, constitutes the principle 
distinction between remitting and intermitting fever, in the lat- 
ter the reaction effecting a crisis terminates the fever, and which 
disappears until the succeeding paroxysm. But where the ef- 
forts of the constitution are insufficient to effect a crisis, the con- 
test continues and the fever is prolonged, constituting remitting 
fever. 

Cftwses.— Remitting or bilious fever is produced by the same 
cause or combination of causes as intermitting fever, such as 
marsh effluvia, exposure to high atmospheric heat when the 
powers of the stomach are feeble and the " internal heat" and 
nervous power are insufficient to maintain a proper balance in 
the circulation and determination to and from the surface; wear- 
ing damp clothes, errors in diet, exposure to wet and cold, de- 
pressing passions, &c. Persons who attend upon the sick, espe- 



24 REMITTING OR BIIIOIJS FEVER. 

cially in cases of malignant disease, by being exposed to the de- 
leterious exhalations from the sick, together with the loss of their 
natural rest, and the confined air in the sick room, are liable to 
be taken sick, and frequently it happens that they will have the 
same form of disease as the patient on whom they had attended. 
Hence it often occurs that where one member of a family is taken 
sick with a '^bad fever" as it is called, other members of the 
family are subsequently taken down with the same form of dis- 
ease. 

Symptoms* — The first symptoms resemble those that usually 
occur in the first stage of intermittent fever, namely: languor 
and heaviness, yawning and heavy sighing, loss of appetite a»d 
distress at the pit of the stomach, pain in the head, back and 
limbs, alternate sensations of heat and cold, followed by a chill 
or by horripilations and languor. 

As reaction takes place and the fever rises, the pains in the 
head, back and limbs are increased. There is much distress at 
the pit of the stomach, with a total disgust for food, nausea, 
retching and vomiting sometimes of bilious matter, at others of 
a glazy mucous without bile; the tongue is thickly furred; the 
whites of the eyes become yellow, and the skin of a yellowish or 
sickly mixture of red and yellow; digestion is lost, and the bow- 
els torpid or very seldom moved; the stools are unnatural, gene- 
rally either clay coloured, or much darker than natural; the 
breathing is more or less oppressed, and a sense of tightness or 
stricture across the chest; the urine is scanty and high coloured; 
the pulse full, frequent, but seldom very hard or tense, and the 
skin is generally dry and hot." 

** These symptoms continue until the succeeding morning, 
when a gentle perspiration appears on the superior portions of 
the body and sometimes over the whole surface. The fever now 
abates, but a crisis is not effected, and the fever consequently 
does not entirely disappear, at least but for a limited period; the 
pulse continuing quick and irritated, and the skin is above its 
natural temperature. Usually in the course of an hour or two, 
the fever again rises, and continues as during the preceding day 
and night, and then abates for a short time in the morning, and 
in this way the struggle between the vital powers are the cause 
of disease, and continues until a crisis takes place, and the pa- 
tient becomes convalescent, or the disease assumes a more ma- 
lignant character by the vital energies becoming exhausted, in 
the struggle. There is however great diversity in the symp- 
toms and character of what is termed remitting or bilioiis fever, 
scarcely ever two cases presenting precisely the same aspects or 
regular train of symptoms. Thus in one the liver may be more 
disordered, and tliis will modify the symptoms ; in another the 



HEMITTING OR BILIOUS FEVER* 25 

liver may be less and the stomach more deranged, and the symp» 
toms will be modified accordingly. The degree of loss of vital 
force tends to modify the symptoms to a great extent. 

In most instances of remitting fever the symptoms are worse 
on every alternate day. 

In some cases the remissions or declining of the fever oc- 
curs soon after day light, in others after the sun is up, and in 
others not until noon or after. Great variations also occur in 
relation to the degree and duration of the remissions. In some 
the fever Avill almost or entirely disappear for an hour or two, 
or even for three or four hours, wliilst in other cases the fever is 
so slightly moderated as scarcely to be noticed by the patient or 
attendants. In some rare cases the remissions are observed to 
occur in the evening or during some part of the night. 

The disease continuing beyond the fifth or sixth day without 
forming a crisis or assuming a milder aspect, tlie vital powers 
will begin to give away, and if it continues unchecked over the 
ninth day or second week, the symptoms are very liable to assume 
an aggravated and sometimes dangerous character. Seated ori- 
ginally in the stomach, which may be A^ery properly termed the. 
** throne of life," as the functions of this organ are impaired and 
its energies weakened, so in proportion will other organs, such as 
the brain, liver, &c. become disordered, and the vital powers be 
prostrated. The tongue then becomes more thickly coated with 
brown fur, *^ delirium occurs more frequently and strongly; the 
skin acquires a more deeper tinge of yellow;" the bowels be- 
come tender to pressure, and distended with flatus; there is fre- 
quently an acrid heat on the surface, and a burning pain in the 
stomach and bowels, probably from the presence of vitiated acrid 
secretions ; and in frequent instances there are offensive dis- 
charges from the bowels; almost continued restlessness and ina- 
bility to sleep. 

In some instances the liver is prominently affected, loosing 
entirely the i)ower of secreting bile, and in a state of congestion, 
causing a sense of great fullness and pain in tlie right side; vio- 
lent retching and vomiting, ^^ without the ejection of hiUj the 
matter thrown up consisting of glassy mucous j^' together with 
what may have been taken into the stomach. There is great 
torpor of the bowels; the tongue clean, or seldom remains furred 
but for a short time, beginning to clean along the middle; and to- 
wards the termination of the disease a copious discharge from the 
bowels of a dark pitch-like matter. ^^ The liver frequently re- 
covers its action and relieves itself by pouring a large quantity 
of black bile, or perhaps blood, into the bowels, as is manifested 
by the copious, dark coloured or tar like alvine discharges, which 
usually occur in such cases. These large and very peculiar dis- 
charges, may indeed be regarded as the favourable crisis of such 

D 



S6 EEMITTIKG OH BILIOUS rEVER. 

fevers; for convalescence generally soon follows their appear- 
ance, and except the disease be arrested by remediate treatment 
in the early period of its course, there are but few recoveries in 
which such discharges do not occur.'' In this form the stomach 
is doubtless the original seat of the disease, the loss of action 
in the liver being a consequence of loss of power in the stomach. 
The symptoms accompanying remitting fever present an almost 
infinite variety of modifications, but which it would be useless to 
attempt to describe, as the disease in all its diversity of charac- 
ter requires to be treated upon the same general principles. 

Favourable signs. — A general perspiration with a warm skin; 
a soft pulse; the appearance of scabby eruptions about the mouth; 
the urine depositing a copious sediment; the nervous system 
maintaining its integrity; and the tongue moist and beginning to 
clean- 

Unfavmirahle symptoms, — Low muttering delirium; a tym^ 
panitic state of the abdomen; involuntary offensive discharges 
from the bowels; a very diminished secretion of urine ; the 
tongue soft and relaxed, possessing no elasticity; hiccougli; the 
skin relaxed and inelastic, by pinching it up it returns to its 
natural position very slowly; cold wrists and hot hands, and 
the breath and perspiration having a peculiar death -like odour. 
Where there is a cliain of these bad symptoms existing, the case 
may be considered as almost hopeless. Still recoveries do occa^ 
sionally take place where many of these symptoms have existed. 
I have known patients recover in whom there was at the same 
time continued low muttering delirium, involuntary discharges 
from the bowels, tympanitic state of the abdomen, hiccough, 
twitchings of the tendons, picking of the bed clothes, deep heavy 
sighing, and cold sweats over the face and breast. It frequent* 
ly happens that a patient has a symptom which is considered as 
indicating great danger, hiccough for instance, but when uncon^ 
nected with other bad symptoms, this nor any other single symp- 
tom is to be considered as a necessary cause of alarm. 

Treatment of bilious remitting fever,— -A prompt and perseve- 
ring course of treatment should be instituted in the early stage 
of the disease, with a view to cut short its course, and thus pre- 
vent the disease extending to other organs than those primarily 
affected. 

Thomson's course of medicine constitute the most effectual 
means not only for hastening the crisis, but for relieving the 
symptoms. Tiie course of medicine should be repeated daily in 
the first stage of the complaint, or at longer or shorter intervals 
as the case appears to require. Where there is violent pain in 



REMITTIJfG OR BILIOITS FEVER. 27 

the head with a high fever, it will be proper to commence the 
cmirse by an enema, containing a portion of lobelia. One or two 
teaspoonsfiill of lobelia powder administered in this way in luke- 
warm water, and retained fifteen or twenty minutes, will not 
only relax the system, but in most instances w^ill answer the 
place of an emetic given in the usual way. This method of pro- 
ducing relaxation is very effectual, and is of the first importance 
in the treatment of acute disease when the arterial system is 
struggling liard to overcom^e obstructions to the circulation of 
the blood, and it also tends to equalize the nervous influence, and 
aids in restoring the secretions. Whenever the system is re- 
laxed by lobelia, the face, breast, and hands, should be bathed 
with vinegar and water, spirits, or camphor and water; this 
affords great relief to the patient: the external covering should 
not be so great as to oppress or distress the patient. There are, 
however, no bad consequences to be apprehended from an emetic 
given in the usual way, even where there is a violent determina-^ 
tion of blood to tlie head, the symptoms being in almost every 
instance relieved by the vomiting. 

During the intervals betw^een the courses of medicine, pure 
stimulants, as composition or capsicum tea, should be given oc-^ 
casionally, and frequent broken doses of lobelia, either in powder, 
infusion, tincture or in pills. 

When the fever is very Iiigli the face and breast, and even the 
whole surface may be bathed with cold water, vinegar and water, 
alcohol, brandy, camphor and water, or salairatus water. This is 
more especially adapted to the early period of the disease, or 
when the vital powers are sulliciently strong to bear these cold 
applications to tlic surface. Bathing the surface with whiskey is 
pei'fectly safe however in any stage of tiie disease, and wdiere 
the patient is greatly exhausted this will generally afford relief 
and apparently give strength to the system. 

A great variety of teas and preparations for drink may be used 
in fevers, as pennyroyal, balm, mint, lemonade, apple tea, crust 
coffee, &c. A tablespoonfuli of cold water may be frequently 
taken where the thirst is urgent and the patient desires cold 
drinks. 

Where the brain is much affected the feet should be kept warm 
and occasionally placed in warm water, containing mustard and 
salt, or hickory ashes. Injections are of especial benefit under 
these circumstances in diverting the nervous influence and con- 
sequently the blood from the head to the bowels. Not only in 
this are the enemas beneficial, but they relieve the bowels and 
aid in restoring their lost function. I have occasionally observed 
discharges of black vitiated bile evidently from the liver, by 
relaxation produced from an injection of lobelia, the obstruction 



SB REMITTING OR BILIOUS FEVER. 

in the liver is in this way overcome, and the organ enahled to 
relieve itself from a state of congestion and oppression. 

Further remarks in relation to the course of medicine. 

1st. Of steaming.— When the patient is unahle to sit up, or 
the system relaxed by the lobelia injections, the vapour should 
he applied according to the directions given for steaming in bed; 
and during the operation, the surface may be sponged with sim- 
ple cold water, or combined with vinegar or spirits, I have 
Lad patients in a vapour bath on a couch or mattrass from an 
hour to an hour and a lialf at a time, and without proving in the 
least degree debilitating, but in many instances, by proper atten- 
tion, grateful and refreshing. 

In a case of recovery from one of the worst forms of fever, and 
when the patient had symptoms which are generally considered 
as denoting a fatal termination, the patient was steamed in this 
way every day, for eight or nine days in succession, and with 
the most marked benefit. Where the heat of the surface is high 
it will be difficult to excite perspiration even by the vapour, with- 
out reducing the heat of the skin by bathing with whiskey or 
vinegar. When the skin is in a relaxed condition, and the pa- 
tient subject to profuse perspiration, the surface should be bathed 
with No. 6 after steaming. The shower bath is proper after 
steaming, provided the patient is able to setup during the steam- 
ing. A sudden dash of a pitcher of cold water over a patient in 
fever has been observed to be followed by perspiration and an im- 
provement in the disease. 

2d. Of the emetic. — It is always proper to prepare the emetic 
in bayberry tea, and the stronger the decoction the more effec- 
tually will it cleanse the stomach. In the early period of the 
disease, when the fever is violent and the tongue dry and parch- 
ed, the lobelia powder should be steeped in the bayberry tea, 
adding the nerve powder or scull cap, and then strain, and half 
a teaspoonfull of capsicum added to each dose; or the patient 
may take the pepper separately in tea. In a later period of the 
disease, when tlie strength is greatly exhausted, the third pre- 
paration of lobelia may be used, adding a portion of lobelia 
powder. 

The following is a good form. 

Two teaspoonsfuU of the liquid of the third preparation. 

One teaspoonfull of green lobelia. 

And a teacup half or two-thirds full of bayberry tea, 

To be well sweetened and taken at once, and the same re- 
peated two or three times, or as often as is foiuid necessary. 



REMITTING OR RILIOUS TEVEil. ^9 

I frequently give emetics without the application of the va- 
pour bath; thus in low forms of fever, more especially if attended 
with delirium I have repeated the emetic three or four times in 
twenty -four hours without steaming, and continued this treat- 
ment for several days in succession, and with the most signal 
benefit. The propriety of administering the emetic frequently 
must be judged of by the effect produced. After the emetic or 
during its operation, in the early stage of the disease, the patient 
should take the crust coffee, barley water, or elm gruel, and be 
be careful to avoid taliing raw milk, solid food, or sweet cakes, 
wiiich are almost sure to oppress the stomach and aggravate the 
disease. When the strength is exhausted by the continuance of 
the disease, and more especially if there are typhoid symptoms, 
essence of beef, milk porridge and pepper; wine whey with car- 
bonate of ammonia will be proper, together with pepper tea, 
pepper sauce, No. 6, or bayberry tea and third preparation. 

Injections, — These cannot be administered too often; it is ad- 
visable to give one both before and after the emetic. In very 
bad cases attended with delirium, and a tympanitic state of the 
abdomen, I have found it necessary to use a tablespoonfuU and 
even more of the third preparation of lobelia in each injection, in 
order to produce a sensible impression upon the bowels. 

The second steaming: — It is not in all cases necessary to ad- 
minister the bath after the emetic: nor should the patient be 
disturbed so long as he is comfortable and in a perspiration; 
when this ceases and the patient becomes uneasy, then it will be 
proper to give the bath. When tlie patient can set up he should 
be showered with cold water, or waslied with vinegar or spirits; 
if in bed, change the bed clothes and also the clothes of the pa- 
tient. 

After the course a hot brick or bottle of hot water should be 
placed at the feet Avrapt in a damp cloth, and if the patient can 
bear it, have one kept to the stomach. Care is necessary how- 
ever not to oppress and distress the patient with external heat, 
more especially when there is fever. 

When there is great tenderness of the abdomen, flannels wet 
with No. 6, or pepper sauce should be applied, and also a hot 
brick to favour perspiration and a proper action in the skin. 
A mustard plaster or pepper poultice is sometimes beneficial in 
such cases; but the mustard should be removed before it causes 
a blister; when the skin becomes red and the patient complains 
of its burning, it must be removed. 

As the tongue becomes moist and manifests a tendency to clean 
at the edges, the " canker medicine" should be used, in combi- 
nation with stimulants and tonics. A tea cup two-thirds full of 



so REMITTING OR BIlIOUS TEVER. 

bayberry tea made very strong, adding a teaspoonfiill of eompo° 
sition ill powder, is one of the most elBfectual remedies for scour- 
ing the morbid secretions from the coats of the stomach. This 
or some other form of the bayberry or No, 3, should be given 
two or three times a- day. 

In all malignant forms of disease termed fevers, where there 
is a strong tendency to putrefaction, No. 3 or bayberry in strong 
decoction, adding the No. 6 or third preparation of lobelia, are 
probably the most effectual of all other remedies. 

The pepper sauce has also obtained high repute as a medicine 
in malignant fevers. 

Tonics, — As the secretions become restored and the tongue 
clearing, together with complete cessations of fever, the tonics 
recommended in the treatment of intermitting fever should be em- 
ployed. It very frequently happens that remitting terminates 
in intermitting fever or ague. Badly treated cases of ague are 
also often converted into remitting fever. 

A tea of the Virginia snake root is proper as a drink in any 
stage of the disease, and at the same time tends to support the 
strength. A tea of the scull cap or of the valerian may be used 
as a nervine, or the powder added to the other medicines. 

Biet^—'Dunn^ the early stage of the disease and until it as- 
sumes a favourable aspect, great attention to diet is necessary. 
When the stomach is unable to digest food, as is the case in the 
early period of remitting fever, nothing should be allowed the 
patient but crust coffee, barley water, elm gruel, &c. Many 
patients are injured by taking improper articles of food that the 
stomach cannot digest. 

In a more advanced period of the disease, essence of beef, 
chicken water, and mulld egg may be taken provided they are 
found to set well on the stomach. 

In a sinking state of the system wine-whey and carbonate of 
ammonia, or essence of beef are necessary to support the system 
in the way of nourishment. 



SECTION III. 



TYPHLS, CONGESTIVE, AND YELLOAY FEVER. 

Designated by medical ^Titers as different and distinct dis- 
eases, are but various modifications of a malignant disease, and 
consisting essentially in great prostration of the living powers 
or principle of life. 

Intermitting, remitting, bilious, continued, congestive and ty- 
phus fevers, (as they are termed) may arise from the same cause 
t)r combination of causes. They also are liable to run into 
each other as the cause of disease is more or less powerful, or as 
the vital powers become weaker or stronger. Thus an inter- 
mittent may by bad treatment or other depressing influence, be- 
come a remittent, and if the liver should be prominently disor- 
dered, the disease will receive the name ^* bilious remittent" 
jBy a still further prostration of the vital powers, the disease may 
assume the congestive or typhus character. Then if nature 
should gain ascendency over the disease, the symptoms may re- 
assume the remittent type or the disease terminate in intermit- 
tent fever or ague. 

In persons of depraved or drunken habits, the recuperative 
powers are depressed or impaired, consequently under these cir- 
cumstances, disease is liable to assume a malignant character. 

Continued exposure to poisonous eflluvia from the decomposi- 
tion of certain vegetables, or to exhalations from the body of one 
affected vrith a malignant disease, as yellow or typhus fever, by 
degrees and in an insidious way, may poison the system and 
prostrate the vital powers so low as to destroy the power of gen- 
erating heat and nervous influence, and the patient sink into a 
dangerous state of extreme debility and stupor, which would be 
called yellow or conjestive fever. 

In some instances, from the force of the cause of disease, the 
vital energies are suddenly overwhelmed or the principle of life 
destroyed, the system being in a state of complete stupour and 
insensihility, as if stunned by a blow upon the head, or poisoned 
by a large dose of arsenic. Disease of such deadly character 
seldom occurs however in temperate latitudes, being confined 
principally to certain localities in hot climates. Not that a high 
temperature occasions the disease, but heat combined with mois- 
ture, gives rise to malaria or the deleterious gases which poison 
the system. Typluis and congestive fever prevail mostly during 
winter, but it very rarely happens that patients die without some 



32 



TYPHUS, CONJESTIVE ANlI 



tlegree of reaction occurring, as sometimes happens in particu- 
lar localities in hot climates. 

The following case tends to illustrate the insidious and dis- 
guised manner in which disease of the most malignant character 
sometimes takes hold of the system. A young man of this city 
whose health had become impaired by a succession of colds, be- 
came subject to bleeding at the nose, which occurred at frequent 
intervals, during the term o! some weeks. In this exhausted 
state he bailed some offensive v* ater from a cellar that was very 
damp, and he remained in the cellar for some hours. Soon after 
this he grew worse, and I was desired to attend him. He was 
able to walk about the room though extremely feeble and dull; 
he would converse, though with considerable hesitation; his skin 
was of the natural temperature or nearly so, but pale, relaxed, 
and without elasticity; his tongue was but very slightly coated, 
scarcely sufficient to change its natural appearance, and the 
pulse was apparently natural, manifesting no indications of ir- 
ritation or unnatural excitement. This patient gradually sunk 
and died in about two weeks, though the most powerful stimu- 
lants were used with a view to arouse the energies of the stomach 
and bring on reaction. There w^as no sign of fever, except an 
accasional flush on the cheeks towards the termination of the 
disease, neither did he complain of pain; and the stomach ap- 
peared altogether insensible to the most active stimulants from 
the commencement. There was a moisture on the skin during 
nearly the whole period of his illness. There was a peculiar 
expression of tlje countenance — a vacant stare, as though the 
chain of sympathies were broken up, and the brain not perceiv- 
ing what was going on in tlie system. This peculiar expression 
of countenance which might not be noticed by a common obser- 
ver; together wdth what is termed the ^' sardanic laugh" are 
always alarming. 

The sudden deaths sometimes occasioned by drinking cold 
water in very hot weather, and the system exhausted by hard 
labour or over exertion. Dr. Thomson says are owing to the loss 
of inward heat, occasioned by the cold water, and the outward 
heat being high there is a balance of power between the outward 
and inward heat, and that w hen this takes place the blood ceases 
to circulate. *^ The inward heat'% says Dr. Thomson, *'is the 
fountain of life, and as much as that has the power over the 
outward heat, so much we have of life and strength, and when 
we loose this power of heat our strength and faculties decay in 
proportion." The fatal diseases called ** yellow and spotted 
fever," Thomson says, are caused by the loss of inward heat, or 
by a balance of power outward and inward. 

This theory of Thomson would appear perfectly plain and 
consistent with the laws of life and motion, provided there be no 



YELLOW FEVER. S3 

distinction made between animal heat and the electro-galvanic 
or nervous fluid. They are evidently in inseparable connection, 
but it is usual, and doubtless proper, to make a distinction. Then 
the cause of sudden death under the circumstances above alluded 
to. may be owing to the immediate and total suspension of the 
power of generating nervous fluid, and as the circulation of the 
blood depends upon continued currents of nervous fluid pass- 
ing from the center to the surface, the moment it ceases to be 
generated, the blood must cease to circulate. The direct tjen- 
dency of all poisons is to suspend the functions of calorification 
and inervation. Thus a large dose of arsenic taken into the sto- 
mach, immediately destroys the power in the system of produc- 
ing heat and nervous energy, and death becomes more or less 
sudden in proportion to the quantity of poison taken. If the 
dose is large there will be no reaction, nor any trace of inflam- 
mation discernible in the stomach after death; the vital princi- 
ple being suddenly destroyed, without the power of making an 
effort at reaction. But if the dose be not suflicicnt to destroy life 
under three or four days, there will be more or less reaction, and 
the stomach will take on inflammation. The inflammatory ac- 
tion is the struggle of nature against the effects of the poison. 
The term congestive or yellow^ fever would seem almost as ap- 
plicable to such a case as to the cases of malignant disease, pro- 
duced by poisonous agents in the air, and which sometimes de- 
stroy the vital principle almost as effectually as a large dose of 
narcotic poison. 

It has been observed in frequent instances were patients have 
died suddenly from yellow fever, that no traces of inflammation 
were discoverable in the stomach by examination after death; 
precisely as in a case of sudden death from a powerful dose of 
arsenic, the principle of life being suddenly destroyed, without 
the occurrence of fever or inflammation. 

The character of disease is as much modified probably by the 
condition of the system at the time the patient is exposed to the 
exciting cause, as by the power of the cause itself. Thus the 
same exposure to cold and dampness that would produce high 
inflammatory fever in one, would cause typhus fever in another; 
and the greater tlie loss of power in the stomach the more liable 
the system will be to malignant forms of disease: And like= 
wise whatever organ is weakest will be the more liable to be 
especially diseased. Thus, in some, the brain becomes early- 
affected^ whilst in others the liver is prominently disordered, and 
in ethers again the disease will be chiefly concentrated in the 
stomach and bowels, which is probably in all cases the original 
seat of disease caUed fevers* 

'' I remember with pain," says Dr# Eberle, " the unfortunate 
lot of an amiable and intelligent friend. He was a man of healthy 

E 



34 TYPHUS, CONGESTIVE AND 

constitution and fond of indulging in the pleasures of the table- 
He was seized with simple sjnochal fever from cold. His phy- 
sician bled moderately; the fever went on uncliecked; he bled 
again and again daily; after the seventh bleeding there was 
still too much quickness and tension in the pulse; the lancet was 
inserted the eighth time, and the patient sunk almost immediately 
into a state of collapse. Stimulants, both external and internal, 
the most diffusive and potent, were now diligently applied, but 
all in vain; he lived but a few hours longer." 

Typhus Fever, — In the commencement of this form of disease 
there is usually much distress felt at the pit of the stomach, an 
entire disgust for food, giddiness or swimming of the head, ex- 
treme debility and dejection of spirits for some days before there 
is any fever. These are called the ^'premonitory symptoms," 
they are however the direct and immediate consequences of the 
cause of disease, and are a more aggravated form of the same 
train of symptoms that occur, in the commencement of ordinary 
*' bilious" or *' remittent fever." 

The premonitory symptoms in typhus fever, usually continue 
a week and sometimes mucli longer, when the patient is taken 
with a chill or rigour, attended frequently with sickness at the 
stomach and vomiting, confusion in the head and extreme de- 
pression of mind. This chilly state continues an indefinite pe- 
riod, varying from six to twelve hours, when symptoms of slight 
reaction occur, constituting a low malignant grade of fever. In 
this stage the symptoms do not differ from those which prevail 
in the more aggravated form of remitting or continued fever» 
But the powers of the constitution give way and the patient sinks 
into a state of " collapse," when the following train of symp- 
toms are presented, variously modified however in differei^t 
cases. 

Symptoms which characterise Typhis Fever. — Extreme mus- 
cular debility; a weak and frequent pulse; a stunned or stupi- 
fied condition of the brain, frequently with low muttering deli- 
rium; the tongue coated with a brown or black fur or crust; 
twitching of the muscles of the face; great difficulty of protrud- 
ing the tongue; " constant recumbrance on the back and sliding 
down towards the foot of the bed from deficient muscular power; 
difficulty of hearing, and insensibility to surrounding objects; a 
peculiar biting heat of the skin; hiccough;" a distended state of 
the abdomen, with tenderness to pressure; the urine pale, and 
foaming like beer when voided in a vessel; and as the disease 
advances there is a tendency to diarrhoea, the discharges being 
acuid and exceedingly offensive: the stupor increases, from which 
it is difficult for the patient to be aroused. Typhus fever, as it 



YELLOW TEVER. 35 

is termed, varies greatly however, in regard to violence, and in 
ike different modifications of the symptoms. 

Favourable sym-ptoms* — -A general moisture over the surface, 
with a warm skin; the tongue beginning to clean along the 
edges; the urine depositing a brick-dust sediment; the delirium 
subsiding, and the patient being able to sleep. A crisis seldom 
takes place until the thirteenth or fourteenth day from the com- 
mencement of thB disease, and frequently not until the end of tlie 
third or fourth week. Recoveries from this form of disease are 
always slow, the patient remaining in a debilitated condition 
both of body and mind. 

Congestive Fever, — This name is applied to those cases in 
which the force of the cause of disease overwhelms the vital 
powers and prevents reaction. The patient continuing in a 
state of stupor and extreme prostration as in concussion of tlie 
brain by a blow upon the head. Wlien the constitution makes 
a feeble effort at reaction, producing a low grade of fever, the 
disease may be termed typhus, but if the prostration of the living 
power is such as to prevent reaction, the disease will then re= 
ceive the name of ^^ congestive fever,^' 

In shattered constitutions, or where patients are exposed to 
bad air, as on ship-board, or in the crowded wards of hospitals 
and jails, remitting fever sometimes assumes the congestive form 
from prostration of vital energy, the patient remaining in the 
chill and stupified, with swimming of the eyes, anxious expres- 
sion of countenance and great debility. 

Congestive Intermittents occur in certain locations in hot cli- 
mates. The chill becomes greatly protracted, and if reaction 
comes on, the fever will be of a low malignant or typhoid grade. 
It has been noticed in those places where malignant intermit- 
tents prevail, that a short chill followed by a vigorous reac- 
tion or fever, is favourable; but on the other hand a protracted 
chill followed by an imperfectly developed fever is unfavourable. 

Yellow Fever. — This form of disease does not differ essentially 
from the two preceding varieties. The symptoms are sometimes 
of a violent character in the commencement of the reaction ; there 
is an intensely hot skin, flushed face, the eyes red, extreme head- 
ache, tormenting thirst, intolerance of liglit, pain in the loins 
and lower extremities, a sense of weight and tension at the pit of 
the stomach, white, and sometimes clean tongue. Distressing 
retching and vomiting occurs, the ejections sometimes so acrid 
as to excoriate the throat. Tiiere is a burning heat and tender- 
ness at the pit of the stomacii, as though the patient had swal- 



36 TYPHUS, CONGESTIVE AND 

lowed some corroding acid; extreme restlessness and deep sigh- 
ing; a hopeless expression of countenance, and frequently dele- 
riiim. 

The fever or reaction seldom continues more than two or three 
days, when the fever subsides without any critical evacuation 
occurring, either by sweat, urine, or stool, leaving the patient 
extremely exhausted with a weak and easily compressible pulse, 
and soon followed with yellowness of the skin and whites of the 
eyes. '' The patient now^ remains in a state of tranquil indiffer- 
ence, amounting to a sort of stupor, without any apparent con- 
cern as to present or future situation. This is an ominious calm; 
for after a few hours the pain and burning sensation in the sto- 
mach return with increased violence; the vomiting becomes fre- 
quent and distressing — the fluid brought up containing minute 
flakes or flocculi, resembling the crust w^aslied from a port-wine 
bottle, but little or no bilious matter," and every thing that is 
swallowed is forcibly ejected. ^*This second paroxysm con- 
tinues commonly from twelve to tliirty-six hours, when the ener- 
gies of the system are worn out in the struggle. The pulse 
sinks, the extremities become cold and clammy, the tongue is 
black, and "the matter thrown up consists of a black ropy 
fluid resembling coffee grounds suspended in a glary fluid." 
The burning in the stomach and bowels is distressing in the ex- 
treme. *^ Diarrhoea usually occurs at this period — the dis- 
charges being green, or black. Hiccough, violent delirium, 
hemorrhages, stupour and convulsions are apt to occur in fatal 
cases." 

Although t]ie above describes the general characteristics of 
yellow fever, still a great diversity of modifications are present- 
ed in different cases. Thus in some instances the principle of 
life is destroyed in the onset of the attack, and the patient ex- 
pires without any symptoms of reaction occurring. **In other 
instances violent and furious delirium, or mania ushers in the 
disease, terminating in a few hours in insensibility and convul- 
sions. " Sometimes it commences and proceeds to a fatal termi- 
nation in so insidious a manner, that the patient himself and 
those about him are scarcely aware that he is much indisposed. 
In such cases there is, however, always a remarkable change in 
the expression of the patient's countenance, as well as in his 
usual temper and habits. In almost all instances of this disease, 
the countenance is expressive of intense anxiety and despair dur- 
ing its early period, and of gloom or sullen abandonment in the 
last stage." I have heard it stated by a physician that of two 
hundred patients sick of yellow fever that came under his care 
during the season of the prevalence of the disease in Philadel- 
phia, no two cases presented precisely the same modifications of 
symptoms. 



YELLOW FEVER. ST 

Treatment of TijphuSf Congestive and Fellow Fever, — In all 
those aggravated forms of disease, an energetic and persevering 
course of treatment should he instituted in the early stage of the 
disorder, before the energies of the system become exhausted. 

The disease commencing with a state of extreme prostration 
and stupour, the third preparation of lobelia should he given free- 
ly, also stimulating injedionSf and friction on the surface; to- 
gether with the vapour hath and stimulating applications to tlie 
skin, with a view of aiding the feeble efforts of the constitution 
in causing a determination to the surface, and in establishing 
reaction. 

The third preparation of lobelia answers several important in- 
dications; besides its emetic properties it is a powerful diffusive 
stimulant, and it also possesses strong anti-ceptic properties. 
The third preparation of lobelia in a strong decoction of the bay- 
berry, I liave usually found more effectual than any other pre- 
paration of medicine in low or malignant fevers. In many cases 
however, the medicine requires to be changed occasionally, more 
especially when disease becomes seated. In some instances the 
pepper sauce will suit the stomach for a time better than any thing 
else. When the tongue is dry and the patient craves acids, the 
pepper sauce will generally be found beneficial. 

A mixture of lemon juice and loaf sugar, in some instances 
will agree with the stomach for a time and be tbe only kind of 
nourishment that the patient can relish. 

Capsicum or Caijenne Pepper. — This is a pure and permanent 
stimulant, and maybe administered in frequently repeated doses. 

Carbonate of Ammonia is a diffusive stimulant, and powerfully 
anti-acid, and may be given dissolved in capsicum tea or with 
other stimulants. 

Wine Whey is also a diffusive stimulant, it also affords nour- 
ishment to the system, and is particularly indicated where the 
disease has continued for a length of time, and tlie system is in 
a state of extreme prostration. As much of the pulverized car- 
bonate of ammonia as will lay on a five cent piece dissolved in a 
wineglass of the whey will overcome the tendency in the whey to 
sour in the stomach. 

The Vapour Bath. — ^' In all cases," says Dr. Thomson, 
" where the heat of the body is so far exhausted as not to be re- 
kindled by using the medicine, and chills or stupor attend the 
patient, then applied heat by steaming becomes indispensably ne- 
cessary." The steam may be applied to the patient on a mat- 
tress or couch. A moderate sweat continued in this wav for an 



38 TYPHUS, CONGESTITE AND 

hour if the patient can hear it, is generally hetter tlian a profuse 
perspiration; in those cases of great prostration. If there be 
fever, or the patient is oppressed, the surface should be bathed 
with whiskey, vinegar, or water, and always when a patient 
faints, dash cold water or spirits in the face. It is very neces- 
sary to pay particular attention to bathing the surface, not only 
during the steaming, but at other times, when the skin is intense- 
ly hot, or the patient very low. After the bath the surface 
should be washed with vinegar or whiskey, or in very low cases, 
strong stimulants should be used, as No. 6, third preparation of 
lobelia, pepper sauce or stimulating liniment. The clothing of 
the patient should be changed frequently. In applying warmth 
to the patient in bed it should be a moist heat when the skin is 
dry or feverish, as from bottles of hot water or hot bricks wrapt 
in damp cloths; and when the patient is in a cold clammy sweat 
a dry heat may be applied, as by bottles of hot water, or narrow 
hags filled with hot sand, salt or ashes, placed by tlie sides of the 
patient extending from the arm-pits to the feet. In a prostrate 
state of the system, or wlien the skin is very dry and hot, care 
must be observed not to occasion so high a degree of heat as to 
oppress the patient. Frequent bathing the surface is of great 
importance in all low or malignant forms of disease. 

It matters not whether the disease comes on with great excite- 
ment and delerium or with a state of congestion and oppression, 
us regards the general course of treatment. The emetic and in- 
jections proper in a state of congestion and extreme torpor, are 
equally applicable where there is great excitement in the system. 
I have in repeated instances observed a dose of the third prepa- 
ration of lobelia given in bayberry tea, to have great influence in 
moderating, and in some instances to overcome delerium; and on 
the return of the delerium, by repeating the dose, these symp toms 
again disappear; and in this way patients have in some instances 
been kept comparatively calm and quiet, and able occasionally 
to sleep, who would have been in a state of extreme restlessness 
and delerium without the medicine. 

If the third preparation of lobelia should produce a sense of 
stricture at the stomach, and pain in the head, as in some rare 
instances it does, more especially where the patient has a dry 
cough, and the secretions of the skin and mucous membrane are 
suspended, then the lobelia may be infused in baybery or com- 
position tea, and strained, and given as a substitute for the third 
preparation. 

It is recommended by some practitioners to use the cold 
shower bath in the first stage of the disease, where the fever is 
vehement. Of thf; utility of this practice I cannot speak from 
experience, never having used it except after the vapour bath. 



YELLOAV FEVER. 39 

In a more advanced period of tlie disease, the patient will re- 
quire to be nourished with wine whey, essence of beef, mulled 
eg^, crust coffee, &c. 

Tonics — "When tlie tongue manifests a tendency to clear along 
the edges, with an occasional absence of fever, tonics will be 
proper, such as are recommended in the treatment of remitting 
and intermitting fever, as quinine, Peruvian bark, Virginia 
snake root, &c. The Virginia snake root may be used, how- 
ever, in any stage of the disease. It answers very well given 
in decoction with capsicum or composition tea. Recoveries 
from these low forms of fevers are usually very slow, and the 
tonics and other remedies require occasionally to be changed. 
Fifteen or twenty drops of the " elixir of vitriol," given in a 
wineglassful of some bitter infusion, forms a good tonic. 

The vapour bath is proper in any stage of the disease, more 
especially if the patient be permitted to lie on a couch, sofa, or 
mattrass, and thus avoid the fatigue of sitting up. "Where tlie 
patient is able to sit up, the shower bath can be given after the 
bath, which is, in many instances, of especial benefit. 

The continued and frequent administration of emetics will not 
always be required Vvhen the disease becomes seated : occasion- 
ally, however, an en^etic may be needed to clear tlie stomach. 
It is in general a good rule to give an emetic whenever the pa- 
tient is oppressed at the stomach, or more distressed than 
usual. 

Patients in a state of convalescence sometimes crave hard 
cider, and under these circumstances, old bottled cider will be 
found to increase the appetite, and to add tone to the stomach. 

In all these lov/ or malignant forms of disease, tlie floor of the 
sick room should be occasionally sprinkled with the chloride of 
soda; or the chloride of lime placed in dishes about the room. 
This will greatly improve the air of the room, and be an advan- 
tage to the patient, and afford protection to the attendants. 

In a recent conversation with Dr. Shaw, who had been prac- 
tising in the west, he mentioned the case of a female who was 
extremely ill with a form of disease that prevailed in that section 
of country, and proved frequently fatal, termed congestive tijphus. 
The patient had retained nothing on the stomach for two days ; 
she had cramps in the limbs, and a tympanitic state of the bowels. 
In this condition the doctor ordered an enema to be administered 
of half a pint of No. 6, which, producing scarcely any impression 
on the bowels, the same quantity was repeated, which was also 
retained, occasioning much distress. Shortly after, another in- 
jection was given, composed of nearly half a pint of the third 
preparation of lobelia. This likewise was retained, causing 



40 TYPHUS, CONGESTIVE AND YELLOW FEVER. 

great distress in the bowels : the patient tossed about in every 
direction. On the following day the patient was able to sit up, 
and recovered rapidly. Dr. Shaw was of the opinion that the 
disease was on the point of terminating in mortification of the 
bowels, at the time these injections were given, but was prevented 
by their influence. 

I knew an instance where injections were repeated and retained 
until ten ounces of the third preparation were contained in the 
bowels at one time. This patient also recovered, after the symp- 
toms had assmued a very alarming character. 

I was called to New Jersey to attend a young man who was 
ill of what is termed malignant fever. I found the patient deli- 
rious ; with a dry and husky skin, and suspension of the secre- 
tions from the mucous membrane. I was informed that on the 
preceding day his physician, who pursued the old school practice, 
attempted to sweat the patient by placing hot dry bricks around 
him, and confining the patient by a cover held by assistants. 
This increased the distress so much, that it was with difficulty 
the patient could be kept in bed, being most of the time delirious, 
with a determination of blood to the head, and burning heat in 
the skin. Had the patient been in a cold sweat, the dry heat 
would have been very proper, but under the circumstances before 
described, such applications cannot prove otherwise than distress- 
ing and injurious. I gave this patient a preparation of salt, 
cayenne pepper, and vinegar, which excited the secretions of the 
mucous membrane, the patient beginning to raise large quanti- 
ties of tough mucous from the throat and mouth. A frame was 
made of hoops, and placed over the patient, and over the frame 
a quilt ; under the quilt was placed a pan containing hot water. 
A hot brick was put in the water, and a steam created, which 
was continued for half an hour, wetting the face, and occasion- 
ally all over the surface with cool vinegar and water. This 
was not only borne well by the patient, but was comfortable. 
He sweat freely, and under the general course of treatment 
pursued in bad cases, he soon became convalescent, and reco- 
vered. 

In bad cases patients will generally experience more or less 
distress under the operation of a course of medicine ; but this in 
general is to be considered more favourable than when the sensi- 
bility is dormant. I have repeatedly known patients to be much 
distressed, for many hours together, under the influence of the 
emetic and injections, and shortly after, the disease take a very 
favourable turn. Patients are generally extremely weak and 
prostrated on the turn of a fever^ or more properly when the 
disease forms a crisis. 



CHAPTER IL 
ERUPTIVE DISEASES, 

SECTION I. 



SMALL-POX. 



This disease is characterized by a peculiar form of eruption 
which affects the skin during the progress of the disease. All 
the other symptoms are such as occur in other acute diseases. 

Small-pox is highly contagious, and may be taken at any 
period of life. Like measles and scarlet fever, small-pox very 
rarely occurs more than once in the same person. 

Previous to the introduction of vaccination by Dr. Jenner, 
the mortality from small-pox was very great ; hence it has been 
dreaded more than any other contagious disease. 

Cause, — Small-pox is caused by a certain specific poison, com- 
municated to the system either by inoculation, or by breathing 
the effluvia arising from the body of one affected with the dis- 
ease. There are cases of small-pox, however, which arise from 
causes independent of exposure to the disease in others. 

From the period when the small-pox poison is first intro- 
duced, up to the time when its influence upon the system is first 
manifested, from seven to twenty days may ensue, though in the 
great majority of cases, this period is between the ninth and 
fourteenth day. 

Small-pox is divided by medical writers into two varieties— 
the distiiict and confluent. There is no essential difference be- 
tween these, other than that the latter is a more malignant form 
of the disease. The eruption, instead of remaining in distinct 
and separate pustules, run together and form irregular masses, 
or patches. In some instances the pustules are coiifluent on th© 
face, while they are distinct over the body. 

Symptoms and course of the distinct or milder variety. — In 
whatever way the small=pox poison is introduced into the system? 

F 



42 SMALL-POX. 

it is carried to the stomach, and upon this organ its deleterious 
influence is first exerted. 

Chilliness and langour, loss of appetite, aching pains in the 
back and lower extremities, great thirst, nausea and vomiting, 
with pain and distress at the pit of the stomach, are the usual 
symptoms accompanying the forming stage of the disease. 

As the constitution reacts, the fever becomes developed, and 
generally, in the course of three or four days, the eruption ap- 
pears. The fever, in small pox, presents the same character as 
ordinary bilious fever, such as a hot and dry skin, furred 
tongue, costive bowels, pain in the head, and scanty, high 
colored urine. Bleeding from the nose is apt to occur during 
the first and second day of the fever. ^^Tiie mind is dejected 
and confused, and towards the end of the third day the tongue 
usually acquires a bright red color." 

^* Shortly before the appearance of the eruption, an unusual 
tendency to perspiration generally occurs in adults, and fre- 
quently much drowsiness, and sometimes coma" (or stupor) * ^su- 
pervenes at this period." *^ In children the eruption is some- 
times preceded by convulsions ; but the tendency to free perspi- 
ration very rarely occurs in them," In many cases the hands 
and feet are cold throughout the whole course of the disease, 
more especially in very young children. 

The eruption first appears on the face, and generally in the 
course of twenty -four hours is spread over the body and limbs, 
^^ consisting at first of red points, which by the middle of the 
second day present small elevations, with inflamed basis, which 
as yet discharge no serous fluid, if punctured, but the cuticle 
appears distended By a sort of semi-transparent plastic lymph. 
Towards the end of the second day, some of these pustules pre- 
sent small depressions in the centre ; and on the following day 
these characteristic depressions become conspicuous in nearly all 
of them. Where there are but few pustules, they often remain 
elevated and pointed, with but a very slight central depression ; 
but where they are numerous they become flattened, with dis- 
tinct depressions in the centre. As the pustules increase in size 
their flattened form becomes more conspicuous. About the fourth 
day they assume a whitish colour, and become surrounded by a 
pale red areola. When the pustules are very numerous, these 
areola run into each other, and give a uniform appearance of 
redness between the pustules. 

The fever always remits or entirely disappears as soon as the 
eruption is fully out. By the fifth or seventh day of the eruption, 
the serous fluid contained in the pustules begins to change its 
colour, ** marking the stage of suppuration." As suppuration 
goes on, these pustules become distended with pus, and losing 
their flattened form, acquire a spherical shape." 



SMALL-POX. 4S 

The face begins to swell, generally, by the eighth day, and 
occasionally the eyes become entirely closed. The fever usually 
returns during this stage of the disease. 

*' Towards the end of the tenth day, the swelling of the face 
begins to subside," and tlie hands and feet, and other parts of 
the body, become sw^ollen and tender. 

Soreness of the throat, and a copious discharge of saliva, al- 
most invariably accompany the suppurative stage. 

** As the disease advances, the pustules become gradually yel- 
lower, and more opaque, and arrive at their full state of maturity 
about the twelfth day. After the pustules have acquired their 
perfect state of development, they sometimes remain stationary 
for several days ; but more commonly a brownish spot makes^ 
its appearance on the centre of each pustule as soon as the pro- 
cess of suppuration is completed, acquiring at the same time a 
rougher aspect, and a deeper yellow. Soon after this change the 
pustules begin to shrink, becoming gradually drier, darker, 
and harder, until the matter is converted into a brown crust." 
These scales are frequently formed on the face, when the '^ pus- 
tules on the extremities have scarcely arrived at maturity." The 
mild form of small-pox rarely leaves the skin permanently 
marked or pitted. 

Such is the process by which the constitution works oif 
from the system the poison of small-pox, — first, by the reaction 
or fever, by which the disease is thrown to the skin, and then 
by certain mysterious actions, there is formed on the surface the 
same specific poison which caused the disease. 

These sanative operations of the constitution, however, are 
liable to be perverted by various causes, and the disease to assume 
a malignant and dangerous character. In some instances there 
is a strong tendency to putrefaction, — *' The heat is acrid ; the 
perspiration clammy and offensive ; watery diarrhoea often oc- 
curs ; the face is bloated and red ; the eyes watery and inflamed ; 
and the appearance of the eruption, and its progress, are irregu- 
lar. The pustules commonly acquire a dark or livid hue; are sur- 
rounded by brown, or almost black margins ; and become filled 
with a bloody serum instead of pus." 

Where the disease is of a violent or malignant character, the 
eruption, instead of being in distinct or separate pustules, appears 
in irregular masses, or patches, by the pustules running together. 
This forms the conjiuent variety of small-pox. 

Corifluent small-pox assumes various modifications. In some 
instances the disease is highly inflammatory, commencing **with 
strong chills, succeeded by intense febrile heat ; a frequent, full, 
and hard pulse ; liigh coloured and scanty urine ; flushed coun- 
tenance; sometimes delirium; and in children often with convul- 
sions." The tongue is dry and harsh, and frequently coated 



44 SMALL-POX. 

with a dark or black fur, with excessive thirst. In some in- 
stances the brain becomes greatly affected, giving rise to violent 
delirium, stupor, and convulsions. 

" The tendency to profuse perspiration, so conspicuous in the 
distinct small-pox, is rarely observed in the confluent variety ; 
but profuse diarrhoea sometimes occurs shortly before the appear- 
ance of the eruption, and still more commonly during the suppu- 
ration." The pustules are generally '' irregular in shape, and 
much less elevated than in the distinct small-pox, and the parts 
not covered with the eruption are pale and flaccid." 

**In the more aggravated instances of confiuent small-pox, it 
often assumes a typhus cliaracter." <*The chilly stage is un- 
usually protracted; the pulse remains small, weak, and frequent, 
and the patient complains of much muscular prostration. Various 
symptoms of nervous disturbance are apt to occur — such as ver- 
tigo, faintness, twitching of the tendons, and even convulsions. 
The urine is colourless, and the face pale and sunken. The pus- 
tules come out slowly and irregularly, appearing simultaneously 
on every part of the bod}^, yet sometimes first on the extremi- 
ties." <*The eruption sometimes disappears on some parts 
without passing into the ])ustular state ; and slight causes, such 
as cold, or mental agitation, may cause the whole eruption to 
recede ; in which case convulsions, or apoplexy, or fatal conges- 
tion and effusion into the lungs, are apt to supervene. Suppu- 
ration goes on slowly, and imperfectly ; the pustules becoming 
filled with a tliin watery pus. The intermediate skin is seldom 
much tumified, and remains pale." 

Treatment. — Small-pox should be treated on general princi- 
ples, the same as in other forms of disease accompanied with 
fever. To cleanse the stomach by emetics ; to promote the action 
of the bowels by injections ; and to sustain the vital powers by 
pure stimulants, constitute the most important indications in the 
treatment of small-pox. 

The course of medicine administered in the early stage of small- 
pox, tends to relieve the distress, and to cause the disease to as- 
sume a favourable aspect. The course of medicine, however, will 
be proper at any period of the disease when the condition of the 
patient seems to require it. 

During the cold or forming stage, the patient should be kept 
warm ; but after the fever is established, the covering should not 
be too great, nor the room kept uncomfortably warm. It is also 
important that the room should be well ventilated. The patient's 
clothing should be changed every day, taking especial care that 
the fresh clothing be perfectly dry before it is put on. 

When the pustules are distinct and not yery numerous, and 



SMALL-POX. 45 

the symptoms are of a favourable aspect, it will not be requisite 
to give mucli medicine. An occasional dose of the composition 
or pepper tea; or if the patient be a child, simple herb teas, as 
pennyroyal, sweet marjoram, or balm, will be sufficient. The 
bowels to be relieved, when necessary, by injections. 

When tlie symptoms are very distressing, or the patient unable 
to bear the fatigue of sitting up, emetics may be given without 
previously administering the vapour bath. Much benefit may 
be derived from broken doses of lobelia, wiien the fever is vio- 
lent. 

The Vapour Bath, — During the chilly or forming stage of 
small-pox, more especially when the efforts at reaction are fee- 
ble, and the cold stage consequently becomes more protracted, 
the vapour bath is of essential benefit, and when followed by an 
emetic will seldom fail to bring on reaction. The bath also 
prepares the skin for the reception of the eruption. 

During the eruption, an occasional vapour bath will prove 
beneficial, by promoting the secretions and exhalations from the 
skin, w^hich is one of the principal outlets of disease. In the lat- 
ter stage of the eruption, w^hen the scabs are coming off, the 
vapour bath will be of especial advantage in restoring the skin 
to a healthy condition, and thereby prove a preventive to tlie 
various affections which sometimes follow^ as a consequence of an 
unhealthy condition of the skin. While steaming, the patient 
may be w^ashed or sponged over w ith castile soap and water, or 
with a weak solution of saleratus in w^ater. The temperature of 
the water should be regulated to suit the feelings of the patient. 
A strong decoction of sumac berries and leaves, or of bayberry 
powder, adding a portion of cayanne, maybe given once or twice 
a day, in ordinary cases, or substituted for the composition and 
cayenne, and given several times a day. This also forms a use- 
ful gargle for th€ throat, which is in most instances, considerably 
affected. 

Cold Brinks. — Where the thirst is urgent, moderate quantities 
of cold water, or lemonade, may be allowed the patient, more 
especially after taking a dose of the hot medicine. 

The Diet — During the early stage of the disease but little 
nourishment will be desired. Crust coffee, barley water, elm 
gruel, &c., are suitable in ordinary cases, until the disease is on 
the decline, w'hen a more generous diet may be allowed, as chick- 
en tea, milk porridge, toast and milk, soft boiled eggs, custards, 
&c. In the confluent form of small-pox, where the symptoms 
indicate great prostration of the vital powers, w ine whey and the 
essence of beef should be given as nourishment. Five or ten 



46 SMALi:-POX. 

grains of the carbonate of ammonia may be added to a wine- 
glassfull of the whey, as it tends to prevent acidity of the stomach, 
and also affords a grateful stimulous. Constipation of the 
bowels may he in a great measure overcome by a diet consisting 
principally of unbolted wheat flour gruel, calves' foot jelly, 
stewed prunes, Indian gruel, well boiled, or bread cut in thin 
slices, well toasted, and softened with sweet cream, or boiled 
milk. 

When the disease is of a typhus, or otherwise malignant cha- 
racter, the treatment should consist of such means, both external 
and internal^ as are best adapted to support the prostrate and 
sunken energies of the constitution, and to assist the stomach to 
cast oiF offensive matters, which tend to weaken and oppress its 
powers. I know of no better emetic, in such cases, than the 
liquid of the third preparation of lobelia, in a strong tea of the 
sumac or bayberry. A teaspoonful of the third preparation of 
lobelia to a tea cup half full of the above tea, and the dose re- 
peated every hour or two, should be continued until the symptoms 
become more favourable. I have found it necessary in some in- 
stances, to continue the use of the third preparation for several 
days and nights in succession, together with pepper tea, wine 
whey, and carbonate of ammonia. 

In some instances, the lobelia powder, put in hot baybeiTy 
tea, and then strained, answers better than the third preparation 
of lobelia. 

The patient's clothes and bed-clothes should be changed fre- 
quently. A feather bed should be avoided, except in the middle 
of winter. 

The <* inward heat" should be maintained, to keep a determi- 
nation to the surface. This may be accomplished, in ordinary 
cases, by an occasional dose of composition or pepper tea, or by 
simple ginger, or pennyroyal tea. 

During the progress of suppuration, but more particularly 
when the scabs begin to form, patients are very liable to be 
restless and greatly distressed. There is probably no remedy 
for this equal to the vapour bath. I have seen patients in great 
suffering and distress, rendered comparatively comfortable and 
quiet, in a few minutes after applying the vapour bath. Applied 
in bed, as directed for steaming in bed, the patient will bear it 
from half an hour to an hour, and even longer. During the 
steaming, the surface should be w^ashed over freely with castile 
soap and tepid water, or saleratus water, and after the bath, the 
bed-clothes, as well as the clothes of the patient, changed. 

I knew an instance where a patient being steamed at a time 
when the scabs were fully formed, and almost dry, that they 
came off in a body, and left the surface almost ^^raw,*' the dis- 
ease having been of the confluent form, and the eruption covering 



SM AIL-POX. 47 

almost the entire surface. An ointment made of sweet oil and 
lime water was spread on soft clotlis, and applied over the body, 
and in tw^ or three days the soreness was principally removed. 
Tiiis circumstance afforded an opportunity for gossips to astonish 
tlie neighbours by their description of the terrible ejects of steam: 
fortunately for the ^^ steam doctor," however, the patient reco- 
vered rapidly after. 

During any stage of the disease when the skin is very hot, the 
surface may be sponged occasionally with tepid water, and the 
external co^^ering be kept light. It is injurious to a patient to 
keep his room very hot and close. The disease is more danger- 
ous in hospitals in consequence of the vitiated air. 

Tincture of lobelia and water answers very well to sponge the 
surface with ; but all kinds of oils or fat should be kept off, as 
they finally tend to aggravate the distress. A mixture of lime- 
water and sweet oil may be applied with benefit. The mucillage 
of slippery elm will afford relief, and may be applied to various 
parts in the form of a poultice. 

Camphor Liniment.—*^ Take of camphor, half an ounce ; olive 
oil, two fluid ounces. Dissolve the camphor in the oil.'' This 
liniment is recommended as a means of preventing, or at least 
lessening pitting of the skin on the face. It is directed to be 
used in the early stage, soon after the eruption appears. 

The eleventh and thirteenth days are said to be the most dan- 
gerous periods of the disease. 

During suppuration^ or in the latter period of the disease, the 
system should be nourished by the most nutritious diet that the 
stomach can take, such as wine- whey, milk porridge, essence of 
beef, mulled egg, &c. And in order to sustain the system in the 
latter period, the stomach should be well cleansed in the early 
stage of the disease, by courses of medicine. It is not in every 
case, however, that nourishing food can be taken, except in small 
quantities ; and under these circumstances, pepper and other 
stimulants must be used to sustain the restorative actions. 

To prevent Pitting. — Professors Chapman and others recom- 
mend slippery elm mucilage spread over the face, and covered 
with gold leaf, such as is used by the dentists, and to be applied 
on the third day of the eruption. I have tried the gold leaf in 
one case, but it did not succeed ; the case, however, was of a 
desperate character, and I cannot say how it might ansvvcr in 
less violent cases. Others recommend the application of a sheep's 
caul, kept over the face, in order to exclude the air. To pre- 
vent pitting, it is important to exclude the light as well as the 
air. The gold leaf might be spread over the caul, which would 
prevent tke admission of light. 



■■ 



48 SMALL-POX. 

When the eyes are very sore, they should be kept covered 
with soft cloths wet frequently with rosewater or raspberry-leaf 
tea. 

Small-pox attacking females in a state of pregnancy, is con- 
sidered by the medical profession as always dangerous. 

The distinct variety of small-pox seldom proves fatal under 
judicious Thomsonian treatment; and even in the confluent form, 
unless under unfavourable circumstances, the system, by proper 
assistance, will ** work out its own salvation." When the vital 
powers are greatly prostrated, and the disease assumes a typhoid 
or malignant character, it almost always proves fatal. 

Favourable Symptoms. — A well developed eruptive fever; the 
pustules remaining distinct, round, and filling with thick yellow 
pus, and a blush or areola, encircling their base. 

Unfavourable Signs* — When the reaction or fever that brings 
out the eruption is imperfectly developed, indicating want of vital 
power; a sudden subsiding of the swelling of the hands and face, 
with pallid countenance, or a striking in of the eruption, the case 
may be considered as of a highly alarming character. When- 
ever the symptoms assume an unfavourable aspect, a thorough 
course of treatment is required to arouse the sinking energies of 
the system. 

^ Case. — I was called to attend on Mrs. P , who had 

violent symptoms of approaching abortion. She was in her third 
month of pregnancy,— a period at which abortions are very 
liable to occur. A full course of medicine was given, which 
eased the pains for a time. On the following day, however, they 
returned, and I thought abortion must take place. The third 
preparation of lobelia was now given freely, until very copious 
vomiting ensued, when tlje pains ceased and did not again re- 
turn. On the following day an eruption appeared, and which 
proved to be genuine small -pox. The eruption came out so thick 
that it ran together, and formed what is termed the confluent 
small-pox. The case proved to be of a severe character, but the 
patient recovered perfectly, and without having any return of 
bearing down pain, or other symptoms threatening abortion. 

The above case illustrates the safety and advantage of treating 
all violent forms of disease upon general principles, not regard- 
ing the name by which the disease may be designated. Thus, 
the same means that prevented the abortion, were precisely such 
as were adapted to throw the small-pox to the surface. And if 
the symptoms of abortion had been occasioned from other causes 
than that of small-pox poison, still the same general plan of treat- 
ment would be indicated. Thomsonians do not require to w ait 



VACCINATION — COW-POX — KINE-POX. 49 

for a disease to become developed, so that they can give it a 
name before they administer medicine. Hot medicine, and in 
violent attacks, a course of medicine cannot be given amiss. The 
same means that will assist nature in bilious fever, will do the 
same in small-pox, or in any other disease. It is at least pro- 
bable that the thorough treatment pursued in the above case, 
prevented abortion by cleansing the stomach, and throwing the 
small-pox to the surface. 

The question is frequently asked, whether the stimulating 
medicines, given freely, will not make the eruption greater 
than it would have been without it ? To this it may be replied: 
If the disease is not thrown fully to the surface, the eruption may 
be less, but the constitutional symptoms will be more violent and 
dangerous than where the eruption is greater, and the disease 
effectually thrown to the surface by pure stimulating medicines. 
To cast the disease off by the surface is the method established 
by nature, and these curative efforts should be aided. 

I am not in the habit of giving largely, hot medicine, in the 
early stage of the disease, nor to keep the patient covered uncom- 
fortably warm during the fever, nor in any subsequent stage of 
the disease. But a thorough course of medicine will be safe and 
useful in any stage of small-pox, and also the free use of pure 
stimulants. A course of medicine in the early stage of small- 
pox by cleansing the stomach, will tend to lessen the eruption, 
and at the same time remove the disease from the internal organs. 
Chronic affections often follow small-pox, owing probably, in 
many instances, to the disease not being effectually thrown to 
the skin, and the determining powers not kept outward. 



SECTION II. 



VACCINATION— COW-POX— KINE-POX, 

The practice of vaccination originated in England, about the 
year 1796. It was introduced by Dr. Jenner. 

In the year 1775, Jenner, who was then a student of medicine, 
one day heard a dairy maid in the office, in conversation with his 
preceptor, declare that she was not afraid of the small-pox (which 
was at the time prevailing in the neighbourhood) for she had 
taken the kine-pox, and that dairy maids that had taken the dis- 
ease from the cows never took the small=pox. This declaration 
of the milk girl, first gave Jenner the idea of introducing the 
cow-pox by vaccination, as a means of protecting the system 

G 



50 VACCINATION — COW-POX — KINE-POX. 

from small-pox. Although it had heen known in some of the 
dairy counties in England many years previous to the time of 
Jenner, that cows were subject to an eruptive disease which be- 
ing communicated to tlie hands of the milkers, produced pus- 
tules, which protected them from small-pox; yet no one before 
Jenner ever thought of introducing a preventive to the small- 
pox, by inoculation with the cow-pox matter. 

The opposition that Jenner met with from the medical pro- 
fession, in introducing this new practice, was of the most hostile 
character. Two physicians in London went so far as to declare 
through the public journals, that introducing the disease from an 
animal into the human system would convert mankind into a sort 
of mongrel, partaking of the nature both of man and beast. It 
was even denounced from the pulpit^ as an invention of satan, 
and that the devil first introduced the practice by vaccinating 
Job. 

After many years of devoted attention to this subject, Jenner 
presented an essay to the Board of Physicians of London, con- 
taining an account of his experiments in vaccination, and fur- 
nished proof of the protection it afforded against small-pox. 
They, however, returned the essay, with the advice to suppress 
its publication, or otherwise he w^ould be considered as either a 
^'fool or aknave.'^ 

The frightful and ridiculous accounts related concerning vac- 
cination, during its early struggles against popular prejudice, 
were probably not even surpassed in inconsistency, by the mul- 
titude of gross and palpable misrepresentations which are 
** wafted on every breeze," of the danger of steam and lobelia^ 
and the dreadful consequences which they produce. 

The practice of vaccination, however, finally gained the con- 
fidence of many medical men, and it soon became generally 
adopted. Jenner on his first visit to the United States for the 
purpose of introducing vaccination, met with strenuous opposi- 
tion from the medical profession of Boston, where he first landed. 
Dr. Benjamin Waterhouse, then a Professor at Yale College, 
was the first of the medical faculty who adopted vaccination. — 
He introduced it into his own family, and about the same time 
Thomas Jefferson's family were vaccinated; and in a few years 
after, the practice of vaccination became generally adopted, not 
only in England and the United States, but throughout all civil- 
ized countries. 

There is too much evidence to admit of a doubt that vaccina^ 
tion affords a protection, in general, against small-pox: that it 
occasionally fails of affording protection to the system, is equally 
certain ; but it should be borne in mind, that there are many 
assignable causes for these failures, such as, when the matter 
osed is of a spurious character, or its virtue destroyed by long 



VACCIJfATIOX— COW-POX— KIXE-POX. 5 1 

keeping, or where erysipelatous inflammation takes place, and 
destroys the genuine character of the disease ; or where the pa- 
tient is affected with an eruptive disorder, and thus pervert or 
change the vaccine disease. 

I attended a female, not long since, who had the small-pox in 
a most violent form, and wlio had heen vaccinated. On examin- 
ing the mark on her arm, I discovered a large smooth scar, 
nearly the size of a quarter of a dollar, showing that the scah 
must have heen three or four times as large as a genuine vaccine 
scab, and that the inflammation had probably so modified the 
disease as to afford no protection against small-pox. The family 
of this female had been vaccinated, and they all escaped the 
small-pox. It is at least probable, that in the greater part of 
those cases of small-pox that occur after vaccination, the failure 
of vaccination in affording protection, has been in consequence 
of imperfection in the vaccine viris; its nature changed by ery- 
sipelatous inflammation; the vesicle broken, and the fluid escaped; 
or from the scab being injured or rubbed off soon after it is 
formed. 

Concerning Vaccination causing JS^ew Diseases. — That erup- 
tive diseases are sometimes occasioned by vaccination, is admit- 
ted: hut many, and probably the great majority of instances 
of disease, occurring after, and attributed to, vaccination, arise 
from other causes, independent altogether of the vaccine viris. 
How often does consumption, scrofula, and chronic inflammation 
of the eyes, occur as a consequence of small-pox; and great 
numbers also die of the disease. Although small-pox may tend 
to purify the system, as Dr. Thomson asserts, yet there are few, 
probably, who have witnessed bad cases of it, tliat would wil- 
lingly take it, rather than run all the risks attendant upon vac- 
cination. 

Characteristics of a genuine Vaccine Scah. — Not larger in cir- 
cumference than a five-cent piece, nearly round, and an indenta- 
tion, or eye, in the centre; smooth on the upper surface, and a 
bold and regular rounded edge ; of a mahogany colour; and of a 
horny appearance, and brittle. 

How to preserve the Seal). — Kept from the air in a sealed glass 
vial, and in the dark, a scab will continue good for years. 

To prepare the matter for Vaccination. — Take a portion of the 
brittle part, near the middle of the scab=-place it on a piece of 
glass or china, and put a drop of cold water on it. and v.hen suf- 
ficiently soft, masli it with a knife-blade. 



5g VACCINATION COW-POX — KINE*POX. 

Season most Favotirahle, — In very cold or very hot weather 
vaccination is very liable to fail, requiring in some instances to 
be repeated several times before it will take. 

Age. — A child should not be vaccinated until after it is at least 
two months old. The usual time is about the fourth or fifth 
month. 

Frecautions, — Be sure that the matter to be used is genuine* 
Bo not vaccinate a child that is affected with any eruptive dis- 
ease on the skin. Persons predisposed to erysipelas should not 
be vaccinated at a time when that disease is prevailing. 

Flace of Insertion, — The part to be preferred for introducing 
the matter, is just below the insertion of the deltoid muscle, on 
account of there not being so much motion in that part; or it may 
be done below the elbow, or under the knee on the calf. 

The General Characteristics of the Genuine Vaccine Disease, — ^ 
First: little or no inflammation until, or after the third day 
from the time the puncture is made. 

Second: About the fourth or fifth day, a small point of inflam- 
mation, which gradually enlarges, and in about two days a small 
vesicle is formed, which is depressed in the centre, and without 
inflammation in the adjoining skin. The vesicle enlarges, re- 
mains circular, with a regular and well defined margin, more 
depressed in the centre, and a small crust begins to form in the 
centre of the depression, by the seventh or eighth day. 

Third: Between the seventh and eightii days, there is an are- 
ola or blush of inflammation formed around the margin of the 
pustule. This circle of inflammation enlarges, and frequently 
by the ninth day, it will be two or three inches in diameter, but 
remaining circular. The crust in the centre grows darker, 
*' and the turged margin shining, as if the lymph were assuming 
the character of pus.*' 

Fourth : The vesicle generally reaches its acme by the eleventh 
day, when the surrounding inflammation begins to subside, first 
immediately around the pustule, and gradually declines towards 
the circumference, where it leaves, at last a mere ring. 

Fifth: The fluid in the vesicle becomes thick and turbid, and 
soon forms into a smooth crust, of a dark brown, or mahogany 
colour. The crust, in many instances, does not loosen and fall 
ofl" under three weeks. <• It leaves a permanent circular cicatrix, 
about five lines in diameter, and a little depressed, the surface 
being marked by many little j)i^5, or indentations, denoting the 
number of cells of which the vesicle had been composed." 



VARIOLOID — MODIFIED SMALI-POX. 53 

l^t Constitutional Sijmptoms attending the course of the vac- 
cine disease are generally very slight, especially in children. In 
some instances, there are chills and fever, and headache, which 
may need some attention, though generally they soon subside 
without any treatment. The glands under the arm are apt to 
be swollen and sore, and care should be taken to avoid lifting 
the child with the hands under the arms, as is the usual practice. 

Characteristics of Spurious or Imperfect Vaccination,- — First: 
There is generally considerable inflammation and raising of the 
skin, on the second day after the puncture is made. 

Second: The scabbing commences by the third or fifth day 
from the commencement of the inflammation, and runs its course 
in a much shorter time than the genuine. 

Third: There is no depression in the centre of the pustule : 
it is raised up high, and has an irregular margin. 

<< When the inflammation commences on the formation of the 
vesicle, and assumes an erysipelatous character early, with much 
swelling, and the pustule assumes a blue appearance, it should 
not be considered as genuine." 

Local Treatment,-^'W\ien the inflammation becomes so great 
as to require attention, as it often does when the disease is of a 
spurious character, the parts should be bathed occasionally with 
tincture of lobelia, and apply a salve of simple cerate, or a pre- 
paration of sweet oil and lime-water. In some instances, a 
poultice of slippery elm and ginger, kept wet with the tincture 
of lobelia, answers better than salves. In severe cases, accom- 
panied with much pain, the bowels should be relieved by injec- 
tions, and the patient kept slightly nauseated with lobelia, or if 
necessary a vapour bath and an emetic given. Wlien the swel- 
ling is very great the arm should be kept at perfect rest, in a 
sling, or on a pillow. 



SECTION III. 



VARIOLOID— MODIFIED SMALL-POX. 

This is an eruptive disease wiiich bears some resemblance to 
Bmall-pox. It is in general, however, of a much milder charac- 
ter, and runs its course in about half the time required for small- 
pox. 

It is the prevailing opinion among medical men, that vario- 



54 VARIOLOID — MODIFIED SMAXl-POX. 

loid is genuine small-pox, operating upon a system which has 
previously undergone vaccination. 

Symptoms. — The first symptoms are lassitude, langour, loss 
of appetite, chilliness, and bad taste in the mouth. These are 
succeeded by a chill in most cases, followed by fever. The fever, 
in some instances, is as violent as in severe cases of small~pox, 
though, in general, it is of a mild character. 

By the third or fourth day of the fever, the eruption begins to 
appear, and in the early stage, resembles the eruption in this 
stage of small-pox. There is seldom any fever aftei* the erup- 
tion comes out. There is no secondary fever in varioloid, such 
as occurs in the suppurative stage of small-pox. In varioloid the 
eruption generally comes out at different periods, in successive 
crops; first on the face and breast, and often disappears there, 
by the time it first appears on the feet. 

By the fourth or fifth day the pustules begin to dry, and by 
the sixth or seventh day, begin to fall off; whereas, in small-pox, 
the scabs seldom fall off before the fifteenth day. 

The appearance and course of the eruption, in varioloid, is 
very diversified. In many instances there is a rash resembling 
measles, which precedes the eruption. It frequently happens 
that a portion of the eruption dries up in the course of two or 
three days, whilst another portion will become filled witli a 
watery limpid fluid, by the first or second day, and by the fourth 
day, usually burst, and another set will become pustular, some- 
what resembling small-pox pustules, and remain four or five 
days longer before they form into scabs. In some cases the 
eruption becomes confluent, by the vesicles running together in 
masses or patches; but even in this form of the disease, there is 
seldom any secondary fever. 

Varioloid is not often fatal under judicious treatment; much 
less so than genuine small-pox. 

Treatment, — The indications of treatment in varioloid are to 
cleanse the stomach, which is the seat of the disease, by an 
emetic; preceded, if necessary, by the vapour bath; the bowels 
to be regulated by injections; and the constitutional efforts sus- 
tained by pure stim-ulants. 

In the more violent cases, where the patient is much distressed, 
the emetic or course of medicine should be repeated at proper in- 
tervals, as long as the symptoms present an unfavourable aspect. 

In many mild cases, simple herb teas, and a proper attention 
to diet will be sufficient. 

The vapour hath may be employed in any stage of the disease, 



VARICELLA — CHICKEN-POX — SWINE-POX. 55 

and will be of especial benefit where the skin remains in an un- 
healthy condition after the eruption has passed off. 
Varioloid seldom leaves the skin permanently pitted. 



SECTION IV. 



VARICELLA— CHICKEN-POX— SWINE-POX. 

Chicken-pox is an eruptive disease, and generally of a mild 
character. Some medical writers maintain that varicella is a 
modification of small-pox, others contend that it is a separate and 
distinct disease. 

Chicken-pox is almost universally confined to children, and a 
second attack in the same individual is of very rare occurrence. 
Neither small-pox uer vaccination affords any protection against 
chicken-pox, nor does chicken-pox prevent small-pox. 

Peculiarities of Chicken-pox, — In general there is some slight 
fever for one or two days, when the eruption begins to be dis- 
closed, first appearing on the neck and back, in the form of small 
bladders filled with a pellucid fluid, which dry away and disap- 
pear on the seventh or eighth day,— before the small-pox passes 
through its first stage. 

The vessicie of chicken-pox will discharge itself on being 
punctured with a pin. A small-pox pustule is cellular and will 
not discharge its contents if punctured. 

In chicken-pox the eruption comes out in successive crops, 
some drying away whilst other crops are appearing, and thus 
continue for some days. The eruption produces a tingling feel- 
ing in the skin. 

Chicken-pox, however, like other forms of disease, assumes 
various modifications. Severe cases closely resemble genuine 
small-pox, leaving the same kind of pits in the skin. 

Chicken-pox is seldom attended with danger, instances of 
deatli from it being very rare. 

Treatment of Chicken-pox, — Where the case is so severe as to 
demand particular attention, the treatment should be conducted 
on the same plan as is recommended in the mild form of small- 
pox, cleansing the stomach by emetics; injections to relieve the 
bowels, and occasionally some mild stimulant, such as compo- 



MEASXES, 



sition or ginger tea, or herb teas, such as pennyroyal, mint, &c. 
Where large sores are formed, they should be covered with some 
simple salve, to exclude the air, and favour the healing. 



SECTION V< 



MEASLES. 



Measles are contagious, and seldom occur more than once in 
the same individual. 

This disease may be contracted at any period of life; but mostly 
occurs in childhood. The middle of winter is the season in 
which it generally prevails. 

The disease usually becomes developed either on the fifth or 
seventh day after exposure to the contagion; but occasionally it 
is not manifested until two, or even three weeks from the time 
the disease is contracted or imbibed. 

Symptoms,— 'TiestlQSsnesSf chilliness, and shivering; pain in 
the head; an increased flow of tears, and a discharge of watery 
humours from the nostrils, are the usual symptoms in the first 
stage of the disease. Fever comes on; the throat becomes sore; 
there is hoarseness and a dry cough; thirst, nausea, and vomit- 
ing; hurried and oppressed breathing; and pain in the loins and 
back. Sometimes there will be profuse sweating. 

In about four or five days from the commencement of the fe- 
ver, the eruptions aj)pear in small red spots, similar to flee-bites, 
first on the face, and then spreading over the body and limbs. 
As these spots enlarge, they unite and form red patches, of an 
irregular shape, leaving portions of the skin retaining its natural 
colour and appearance. 

When the disease is of a violent character, slight delirium 
often occurs about the third day from the commencement of the 
fever, and in children, convulsions are not unfrequent, a few 
hours preceding the appearance of the eruption. 

The eruption on the face usually reaches the height of its de- 
velopment, on the second day after its first appearance, and on 
the following, begins to fade and subside. The face is mostly 
swollen, and in severe cases, so much so as to nearly preclude 
the sight. The eruption on the body fades away in the same 
progressive manner in which it made its appearance; so that about 



MEASLES. 57 

the eighth day from the commencement of tlic fever, it disappears 
finally on the hack of the hands, where it remains longest. 

Looseness of the howels is apt to take place when the eruption 
begins to decline, which is not unfavourable at this stage of the 
disease; but where a diarrhoea occurs just before the eruption is 
making its appearance, it is to be considered as an unfavourable 
occurrence, as it tends to interfere with the regular progress 
of the disease, or cause it to retrocede. Active purging with 
catliartics may produce the same effect. 

Measles occasionally resemble scarlet fever so closely that it 
would be difficult to distinguish between them. This, however, is 
a matter of little consequence, as the same course of treatment is 
applicable in both diseases. 

Although measles, in general, are not dangerous, yet, in per- 
sons of feeble constitution, and delicate in health, they occasion- 
ally become a very formidable disease, assuming tlieform termed 
congestive, or typhus. In this form of the disease the vital 
powers are prostrate; a proper reaction, or fever, does not ensue, 
or takes place very slowly and imperfectly. The countenance 
is pale, and the breathing slow and oppressed; the pulse feeble 
and laborious; the extremities cold — in short, all the vital ener- 
gies are depressed. Infants are also liable to this form of mea- 
sles. 

Treatment — In ordinary cases of measles, much medicine is 
not required. The vapour bath and emetic in the early stage, 
will lighten the disease, and render the patient much more com- 
fortable; after which warm teas, as composition, ginger, penny- 
royal, summer savory, balm, &c., in order to keep a determina- 
tion to the surface, and promote perspiration, are proper. When 
the disease is of a more violent character, the patient much dis- 
tressed, or the eruption slow in coming out, a full course of med- 
icine should be given, and if the symptoms continue violent, 
repeat the course every day, until there is a manifest improve- 
ment. 

Between the courses an occasional dose of composition or gin- 
ger tea; or if there should be much fever, and the tongue dry, 
give cayanne tea: and if the cough is dry and hard, as is usually 
the case, add a small portion of lobelia to the tea, sufficient to 
produce slight nausea. A teacup full of bayberry tea, made 
strong, should be given at night to an adult, and half the quan- 
tity to children. Injections of composition tea, with a teaspoon- 
ful of green lobelia; or bayberry tea, with a teaspoonful of the 
liquid of the third preparation, to be used as the condition of the 
bowels may require. 

If the weather be cold, the patient's room should be kept warm, 
and of an equable temperature; and the patient avoid exposure 

H 



58 MEASLES. 

to a current of air. Still, a proper ventilation of the room will 
be advisable, which may be effected without risk, when the 
patient is in bed. Where a stove is used in the room, a basin of 
water should be kept on it, to prevent the air from getting too 
dry. 

The diet should be milk porridge, chicken tea, gruel, and such 
other light nourishing articles, as are proper in ordinary fevers; 
avoiding strong coffee or tea, except the black tea. Confection- 
ary or sweet cake should not be given to children, as is fre- 
quently done; they are unfit for them in Iiealth, and much more 
so in disease. 

affections liable to follow Measles*- — There is no disease which 
leaves the system as susceptible to the morbid influence of cold, 
as measles. In fact, the effects which frequently ensue as a con- 
sequence of measles, are more unpleasant and troublesome than 
the primary disease. 

Consumption, inflammation of the lungs, scrofula, diseases of 
the eyes, rheumatism, eruptions about the head, and running 
from the ears, are not of uncommon occurrence after measles. 

The liability to these affections, however, will be greatly les- 
senned when the Thomsonian practice is employed. A vapour 
bath about the time the eruption disappears, and the skin is 
peeling off, will tend to restore a healthy action in the skin, and 
diminisli the liability to secondary forms of disease. If the 
tongue have an unhealthy appearance, and other symptoms which 
indicate a disordered stomach and bowels, a full course of medi- 
cine should be given, and use some stimulants to keep up a de- 
termination to the surface, together with a dose of the bayberry 
or sumac tea once a day. 

Death seldom occurs from measles where Thomsonian treat- 
ment is employed. Under unfavourable circumstances, however, 
as when two or three patients are crowded in a small room, 
badly ventilated; or when it occurs in persons predisposed to 
consumption, or to scrofula, it occasionally becomes an unman- 
ageable disease. 

Biet, — During the first period of the disease, and until the 
patient becomes convalescent, the diet should be light, such as 
elm gruel, rice, tapioca, sago, custards, crust coffee, &c. ; and 
as the disease declines, a stronger diet may be allowed, as milk 
porridge, soft boiled eggs, chicken soup, &c. &c. 

Strict attention should be paid to keeping the feet dry, and to 
avoid exposure to cold and damp weather. 



SECTION VI. 



SCARLET FEVER. 



Scarlet Fever assumes many grades of violence, from a 
very mild to that of the most malignant form of disease. It is 
generally treated of under three varieties. 

First. The simple or milder variety. 

Second. The injiammatorij, where reaction or fever is of a 
high grade: and 

Third. The malignant^ where the vital powers are greatly 
enfeebled by the force of disease: the treatment, however, is to be 
conducted upon the same general principles, varying in prompt- 
ness according to the violence of the disease. 

General character and course of the simple imrietij. — Beginning 
with the usual premonitory symptoms of acute disease, such as 
paleness of the skin, loss of appetite, lassitude and chilliness. 
These continue for an indefinite period, ** varying from one to 
three or four days," when reaction takes place, and the patient 
experiences flushes of heat, pains in the head, loins, and extrem- 
ities; sickness of the stomach; the skin becomes dry and hot, 
and the pulse frequent and quick. 

^^ Generally within the first forty-eight hours after the com- 
mencement of the fever, a scarlet eruption comes out, first on the 
face, and then successively, on the neck, trunk, and extremities." 
**The rash consists of innumerable red points, which, running 
into each other, gives a diffused blush over the skin." In some 
cases the eruption appears in patches, " leaving the skin in the 
intermediate space of its natural colour." 

Usually by the fourth or fifth day, the eruption and fever begin 
to decline; critical evacuations ensue, such as a copious dis- 
charge of urine, depositing a reddish sediment; a general warm 
perspiration; and sometimes diarrhoea. About the eighth day 
after the commencement of the eruption, the skin begins to 
roughen and peel off, at which time there is considerable itching 
over the surface. 

Sometimes the disease assumes a more violent character; — 
there is much distress and sickness of the stomach, together with 
severe head-ache and general weakness. The reaction or fever 
comes on early, •* with a feeling of stiffness and dull pain in the 
muscles of the neck and under the ears, and angles of the jaws." 
The throat becomes swollen, whicli renders it difficult for the 



60 SCARLET FEVER. 

patient to swallow; a hoarseness of the voice takes place, and 
there is a ^^ sense of constriction in the throat." The fever as- 
sumes a higli grade of violence; the skin is dry and harsh; the 
tongue dry and of a hright red along the edges, and over its sur- 
face the little glands, or papillae may be seen projecting. '^ The 
eruption does not come out as early in this as in the milder form 
of the disease, and it is seldom diffused over the wliole surface — 
appearing in irregular and not very large patches, on different 
parts, more particularly about the elbows. In some instances 
the rash disappears, and reappears partially at unequal portions 
of time, but without any corresponding change in the general dis- 
order and the whole duration of the complaint is thus lengthened. 
If the disease begins to decline by the fourth or fifth day of the 
fever, the throat rarely ulcerates, the swelling and inflammation 
subsiding as the disease abates. Where the disease is more pro- 
tracted, ** small ulcers are apt to form on the palate and tonsils^ 
which are soon converted into superficial sloughs." " There is 
always a considerable quantity of viscid mucus secreted in the 
fauces, which often concretes into white flakes on the inflamed 
parts and presents the appearance of ulcers, where in reality 
none exists." As tlie disease gives way, "the sloughs in the 
throat begin to separate, and leave red ulcerated surfaces, which 
generally heal without difficulty. Sometimes, however, instead 
of separating about the eighth day, the sloughs enlarge, become 
brown, and discharge an acrid saneous fluid; and in such cases 
the glands about the neck are generally sv/ollen, hard, and pain- 
ful; and the patient is harrassed with painful diarrhoea and te- 
nesmus. The inflammation occasionally extends into the trachea^ 
and the patient dies under symptoms of acute bronchitis. The 
brain often becomes prominently affected during the eruptive 
stage, giving rise to deep and sometimes fatal stupour. 

Malignant Scarlet Fever, — This form of the disease is marked 
by a general prostration of vital power. The reaction, though 
it may be apparently vigorous in the commencement, soon de- 
clines into a low, or typhoid fever. 

The eruption comes out irregularly, and is usually pale in the 
commencement, but '' acquires a dark, or livid hue, in the pro- 
gress of the disease. The eruption often strikes in soon after its 
first appearance, and in two or three days reappears on some 
part of the body. 

The skin varies in its temperature; generally it is not very 
high, though occasionally there is a burning, acrid heat, over 
the surface. The brain is much affected early in the disease. 
The patient becomes delirious; the eyes are inflamed, and dull, 
and the cheeks suffused with a livid flush, readily distinguished 
from the bright red whicli occurs in a less malignant form of the 



SCARLET FEVER. 61 

disease. *^ The tongue is dry and covered with a brown or dark 
fur, and the breath foetid." The ulceration of the throat assumes 
a very malignant character, and frequently it is converted 
into black and offensive sloughs, accompanied with an acrid se- 
cretion from the nose, which excoriate the parts with which it 
comes in contact. ^*The fever and ulceration of the throat fre- 
quently exist without there being any eruption developed during 
any period of the disease: this is called putrid sore throat. In 
some instances the vital powers are prostrated in the commence- 
ment of the disease to such a degree, that reaction does not take 
place. "The patient becomes pale, faint, and oppressed;" there 
is much distress and oppression at the stomach, with nausea and 
vomiting; giddiness, and a sense of weight in tlie head; and ex- 
treme debility. The breathing is oppressed, and sometimes 
there is a mixture of paleness and lividity on the cheeks. "The 
pulse is slow, irregular, and weak." '*The bowels are torpid 
in the beginning, but towards the termination of the disease, 
diarrhoea almost always occurs in fatal cases." The eruption 
is at first pale, or of a copperish hue, wiiich subsequently be- 
comes purple. 

Malignant scarlet fever, in some instances, terminates fatally 
as early as the second, third, or fourth day. In other instances, 
the vital powers will struggle with the cause of disease for weeks, 
occasioning. a low typhoid fever, until finally, either the disease 
or the energies of the system are exhausted, thus terminating 
either fatally, or in convalescence, 

A milder form of scarlet fever may assume a dangerous cha- 
racter, by two or more patients sick of the disease, being in the 
same room; more especially if the room be small, and the pa- 
tients kept near each other. The exhalations from a patient 
sick of scarlet fever, will sometimes occasion a tingling in the 
nose, and even in the skin of the physician or nurse; and when 
patients are placed near each other, the disease will always be- 
come aggravated by it, and in many instances, prove fatal. 

Scarlet fever, in its mild form, occasionally so closely resem- 
bles measles, that it becomes difficult to distinguish between 
them. The indications of treatment being the same, however, 
in both diseases, the difficulty of determining the name will oc- 
casion no embarrassment in directing the treatment. 

Causes* — Though evidently contagious, still there is the most 
conclusive evidence that the disease is frequently produced by 
atmospheric causes, together with exposure to cold and damp- 
ness. 

Treatment of Scarlet Fever. — A course of medicine, adminis- 
tered in the early period, will generally moderate the symptoms 



62 SCARLET FEVER. 

through the whole subsequent course of the disease, and in some 
instances will almost break it up at once. 

In the mild form of the disease, after giving a course of medi- 
cine, or simply an emetic, as long as the symptoms are of a mild 
character, nothing more will be required than to give occasion- 
ally of some mild stimulant, such as composition or ginger tea, 
or simple herb teas, such as pennyroyal, catnip, sweet marjo- 
ram, &c., and an occasional enema, to relieve the bowels; to- 
gether with small doses of the tincture of lobelia, more especially 
at night. 

Where the symptoms are more violent, ^nd tlie patient much 
distressed, a course of medicine should be administered daily, 
and small doses of lobelia given every hour or two, in composi- 
tion, bayberry, or pepper tea. It is not always requisite to ad- 
minister the vapour bath previous to giving an emetic, as in some 
instances free vomiting should be produced two or three times 
in every twenty-four liours. >yhere the tongue is dry, and the 
patient thirsty, the pepper tea will answer better than the com- 
position. Where the skin is very hot and dry, it will be diffi- 
cult to produce perspiration, even by the vapour bath, without 
frequently washing or sponging the surface with cold water, or 
tepid vinegar and water, or what is still better, sala^ratus water. 
A tablespoonful of cold water may be allowed the patient occa- 
sionally, where tiie tongue is dry. 

Sponging the surface with cold salseratus water, or weak ley, 
may be safely employed during the first two or three days of the 
fever, when the patient is very restless, and the skin hot and 
dry, and the patient is not chilled by it. After this period it 
will be safer to use tepid ablutions of weak ley, or sal^eratus 
water, to reduce the heat of the skin, and quiet restlessness. 

Injections are of essential benefit in the treatment of scarlet 
fever, as they not only relieve the bowels, but tend to equalize 
the circulation. They should be prepared in the usual form, — 
either of composition tea, adding a teaspoonful of lobelia powder; 
or bayberry tea, adding a teaspoonful of third preparation of lo- 
belia. 

In violent cases the injections should be repeated every two 
hours. An occasional injection prepared of lobelia powder and 
warm water, will be found of benefit in relaxing the system, 
when the fever is very high; the injection should be retained in 
the bowels fifteen or twenty minutes. Sometimes tins will occa- 
sion free vomiting, and prove of especial benefit. Care will be 
necessary not to keep the patient too warm, externalUj, when the 
fever is high. A hot stove room is very oppressive to the sick, 
unless water is kept constantly evaporating on the stove, to pre- 
vent the air from becoming too dry. 



SCARLET FEVER. 63 

Precaution — More than one patient affected with scarlet fever 
should never he admitted into the same room^ where it can he 
avoided. This precaution is of the very greatest importance. 

Treatment of Malignant Scarlet Fever. — Generallj, the reac- 
tion commences violently, the system being thrown into a state 
of tumultuous excitement; but, from the power of the cause of 
disease, the vital energies soon become exhausted, and the fever 
assumes a low malignant or typhoid character. In other in- 
stances, the vital powers are overwhelmed in the outset of the 
disease, and are unable to bring on reaction. The patient re- 
mains cold, and in a state of stupor, or he is thrown into convul- 
sions. 

In either case, the treatment should be prompt and energetic, 
consisting of emetics, of either the liquid of the third preparation 
of lobelia, or some other preparation of lobelia, rendered stimu- 
lant by the addition of capsicum, or the No. 6, and given in the 
bayberi'y tea. This, together with stimulating injections, and 
external warmth, will be the surest means of establishing reac- 
tion. To sustain the curative efforts of nature, active stimulants 
should he employed, as the third preparation of lobelia, in com- 
position, bay berry, or capsicum tea, wine whey, and carbonate 
of ammonia. A tablespoonful of capsicum tea, and as much wine 
whey, with about five grains of the carbonate of ammonia, forms 
an excellent stimuhmt in all low sinking states of the system. 

If the skin is dry, a moist heat should be kept around the pa- 
tient, as hot bricks wrapped in damp cloths; but where the skin 
is cold and clammy, a dry heat will be proper, together witli 
warm frictions and stimulants to the surface. 

"The capsicum,'^ says Dr. Eberle, ** appears to be a particu- 
larly valuable remedy in this variety of the disease. This arti- 
cle was first employed in malignant scarlatina, by Dr. Stephens, 
in a very fatal epidemic which prevailed at St. Christopher's, 
(West Indies,) in 1787, and it has since received the decided ap- 
probation of many eminent practitioners." The form in which 
the faculty employ it, is similar to Dr. Thomson's pepper sauce 
— a tablespoonful of capsicum, and two teaspoonsful of fine salt, 
to half a pint of boiling water. Strain, and add an equal quan- 
tity of good vinegar. For an adult, a tablespoonful every half 
hour; for children, a less quantity, in proportion to their age. 
The throat to be frequently gargled or washed with it. ** Ste- 
phens asserts that he employed this remedy in about four hun- 
dred cases, and with surprising success. The ulcers in the fau- 
ces soon cast off their sloughs, and commenced to heal; a general 
pleasant warmth was diffused througli the system; and the vital 
powers speedily assumed a more active condition." There is, 
however, such an antipathy against cayenne pepper, tliat nurses 



64 SCARLET FEVER. 

sometimes refuse to give it, because it makes the child cr)^ and 
they have heard others say it is too hot for children. I have 
never observed any ill effects from the use of cayenne pepper, 
either in the young or old, but many children die, who probably 
might have been restored to health, by a free use of this pure 
stimulant. The capsicum tea I find to answer as well, or even 

S better than tlie pepper sauce, more especially in cases where the 

I stools are of a green cast, or emit a sour smell. As much cay- 

enne as will lay on a five cent piece, and double the quantity of 
composition powder, mixed in a tablespoonful of bay berry tea, 
answers better, in many instances, than giving the tea without 
the powder; the dose to be repeated every two or three hours. 

When the patient is thirsty, pennyroyal, or any other simple 
herb tea, may be allowed to be taken freely. 

Applications to the Throat, externally. — In all cases where the 
throat is much affected, a warm poultice should be applied. This 
may be made of Indian mush, well boiled, adding a portion of 
ginger, and when the poultice is spread, cover the surface of it 
with lobelia powder. The poultice should be renewed, or warmed 
occasionally, and not allowed to become cold. Slippery elm, or 
flaxseed will answer as well as the Indian mush. 

Gargles. — In the early stage of the disease, the tincture of lobe- 
lia answers well as a gargle. The capsicum tea, or pepper sauce, 
however, forms the best gargle in scarlet fever, and may be used 
frequently during the whole course of the disease. Swabbing the 
throat with the capsicum tea, or pepper sauce, is still more effec- 
tual than the use of gargles; and in young children who cannot 
use the gargle, the swab must necessarily be used. This is to be 
done j^with a piece of sponge, or rag, tied firmly on the end of a 
stick. Dip the swab in the preparation, and rub over the throat. 
This is sometimes a difficult operation in children, but the bene- 
fit to be derived from it should induce nurses and parents to be 
persevering in its use. A soft piece of wood placed between the 
jaws, will enable the nurse to apply the swab more effectually. 
The child's head should be held firmly. 

The Diet, in the early period of the disease, should consist of 
liquids, such as barley water, arrow root gruel, crust coffee, elm 
gruel, and gum arabic water. In a later period of the disease, 
a more nutricious diet may be allowed the patient, as milk por- 
ridge, essence of beef, mulled q.^^, and Q^g custards. In a sink- 
ing,state of the system, wine whey, with carbonate of ammonia, 
will be proper. 

Scarlet fever is liable to be followed by dropsical affections, 
from exposure to cold, or inaccuracies in diet, before the patient 



SCARLET FEVER. 65 

has fully recovered from the primary disease. As long as the 
tongue remains coated, or does not present a healthy appearance, 
care should be taken to avoid exposure to cold or dampness; and 
the diet should be confined to such articles as are easy of diges- 
tion. I attended a little boy in Second street, who had anasarca, 
or general dropsy, following scarlet fever. Under the treat- 
ment, the symptoms all became more favourable, and the patient 
began to recover rapidly; but from eating heartily of broiled 
mackerel, which his stomach could not digest, dropsy of the chest 
ensued suddenly, and the case terminated fatally in less than 
forty-eight hours after. 

An occasional vapour bath, followed by a shower batli, and 
the surface rubbed dry, and bathed over with some stimulating 
preparation, as pepper sauce, or No. 6 and water, equal parts, 
will tend to prevent dropsy, or other affections that might other- 
wise ensue, as a consequence of scarlet fever. The spice bitters, 
or other tonics, as Virginia snake root, or Colombo, should be 
given two or three times a day, to assist in restoring digestion. 

Where dropsy has ensued, the bath should be administered 
daily, as above directed, and followed sometimes by an emetic; 
broken doses of lobelia given either in tincture or pills, together 
with an occasional dose of composition or pepper tea; and as the 
swelling subsides, and the tongue becomes more natural, tonics 
will be proper. 

J Case. — T was called to attend a young man who had been 
ill of scarlet fever about a week. The rash had been from the 
beginning, alternately appearing and disappearing. The fever 
was of a low grade, and attended with delirium. The principal 
medicines used in this case, and which proved successful, were 
the liquid of the third preparation of lobelia, in a sti^ong decoc- 
tion of bayberry tea,— a teaspoonful of the former to a teacup 
half full of the latter, repeated every two or three hours, in con- 
tinued succession for several days and nights; togetlier with an 
occasional injection of the same kind of compound. This medi- 
cine always quieted the delirium for an hour or two, and occa- 
sionally under its influence the patient would sleep. As the de- 
lirium returned, the dose was repeated, and these symptoms 
w^ould again subside. The patient generally vomited once or 
twice in the course of twenty-four hours, but seldom complained 
of sickness at the stomach. Under this treatment, together 
wdth an occasional vapour bath, administered on a mattress, the 
patient recovered. The diet consisted principally of wine whey 
and essence of beef. 

The Thomsonian practice is generally successful in scarlet 
fever, when applied in the first outset of the disease, though oc- 
casionally it baffles the most thorough and judicious treatment, 

1 



66 NETTXE-RASH — HIVES. 

The treatment pursued in the above case is given in order to 
point out a course that may prove successful in other desperate 
cases. In bad cases of scarlet fever, the floor should be sprinkled 
three or four times a day with a few teaspoonsful of the chloride 
of soda, or the chloride of lime placed in vessels about the room. 
This is more especially necessary where there are more than one 
patient in the same room. 



SECTION VII. 



NETTLE-RASH— HIVES. 



This is an eruption resembling the rash produced by striking 
the skin with nettles. The skin is raised, and whitish on the 
top, with a hardness and swelling around the margin, and more 
or less inflammation, and is attended with painful itching and 
tingling. 

There is a tendency in nettle-rash to disappear and reappear 
suddenly, and thus continues for several successive days. 

In some instances, the eruption comes on only at night, with 
an itching and tingling over the whole body, and when the skin 
is scratched or irritated, large weals immediately rise up, with a 
paleness or whiteness on the centre, and light red margins, at- 
tended with intolerable itching and stinging pain. 

Occasionally the disease becomes chronic, the swelling remain- 
ing stationary for weeks, or even months. 

Cause. — Nettle-rash is caused by a disordered condition of the 
stomach and bowels. Eating shell-fish will sometimes bring it 
on. Balsam copaiva, where it disagrees with the stomach, will 
occasionally produce this kind of eruption. 

Treatment of JYettle-rash. — The vapour bath, and a lobelia 
emetic, will, in many instances, remove the disease at once. If 
the first operation fail of effecting a cure, repeat it at proper in- 
tervals, until the general health is restored; giving occasionally 
composition or spice bitters; and cleanse the bowels by using in- 
jections, prepared in the usual form. 

In milder cases, purified charcoal, taken in composition tea, 
two or three times a day, together with one or two injections, 
will be sufficient to rectify the constitutional derangement. 

A friend of mine informs me that half a teacupful of saffron tea, 
sweetened, and taken at bed time, will overcome the symptoms. 



ERYSIPEIAS — ST. ANTHONT's FIRE, OR ROSE. 67 

The Diet should be simple; avoiding all gross food. Where 
the disease has become seated, let the accustomed diet be changed 
to other articles of equally nutricious qualities. 

Local Applications. — In recent cases, the tincture of lobelia, 
vinegar and water, or alcohol and water, may be applied imme- 
diately to the eruption. In chronic cases tbe stronger stimulants 
should be applied to the swellings, as the No. 6, third prepara- 
tion of lobelia, pepper sauce, or stimulating liniment, &c. — 
All eruptive diseases of this kind are to be treated upon the same 
general principles. 



SECTION VIII. 



ERYSIPELAS— ST. ANTHONY'S FIRE, OR ROSE. 

This form of disease is characterized by a redness of the skin, 
swelling, a tingling burning pain, and the formation of blisters 
on the inflamed surface. 

Erysipelas probably never occurs except there be previous 
derangement of the general health. Usually the first symp- 
toms are langour, chilliness, headach, loss of appetite, and other 
signs of a disordered stomach. These symptoms are followed 
by two or three days' fever, before the erysipelas makes its ap- 
pearance. In some instances the fever is violent; in other cases 
it is of a milder character, and occasionally, though very rarely, 
the inflammation appears simultaneously with the fever. 

*' The inflammation comes out in the form of an irregularly 
circumscribed stain or blotch, w hich soon spreads over a greater 
or less extent of the contiguous surface." There is always more 
or less swelling, even at the commencement of the inflammation, 
and a burning, tingling pain, but the part does not throb or pul- 
sate, except in very violent cases, and where suppuration takes 
place in the cellular tissue. 

Usually by the third or fourth day, blisters are formed on the 
inflamed surface, filled with a ^^ limpid or yellowish serum." In 
the course of two or three days, the blisters break, occasionally 
forming crusts, or large scales. In less than a week, in favour- 
able cases, the inflammation and swelling begins to subside; the 
skin becomes pale, or of a yellowish cast, and presents a rough 
appearance, and shortly after the old skin peels off. 

Erysipelas is generally confined to the skin, though in some 
instances, the inflammation extends to the adjacent cellular tis- 



6S EHYSIPEXAS— -ST. AJfTHOJfT's FIEE, GE ROSE. 

sue. In cases of this kind, the pain is more severe, and the parts 
become extremely tender, and painful on the slightest pressure. 
The constitutional disturbances are generally severe, and the 
comjdexion sallow, indicating derangement in the functions of 
the liver. Frequently, in the severe form of the disease, suppu- 
ration takes place in the parts beneath the skin, and the patient 
experiences irregular chills. " The redness of the skin and the 
pain subside, but the swelling increases; there is much doughi- 
ness, and the parts remain in this state for some time^* before the 
pus will find its way to the surface. When the fluid escapes, it 
frequently has the appearance of whey, and contains shreds of 
cellular tissue, like tow, or shreds of cotton. 

The face and limbs are most liable to erysipelas. When 
it attacks the face, the swelling, in many instances, is so great 
as to entirely close the eye-lids. More or less mental derange- 
ment usually attends such cases, especially when the inflam- 
mation extends over a considerable portion of the scalp. 

The danger from erysipelas is not great, except when the 
brain is attacked by it, or when it occurs in vitiated or brokem 
down constitutions, and the disease assumes a typhus character. 
There is a form of erysipelas which attacks females about a year 
old, appearing first on the vulva, and subsequently becomes in- 
wardly seated, and generally fatal. I have seen a case of this 
kind, attended with sloughing of the vagina, and where the in- 
flammation finally extended over nearly the whole of the body* 
This patient died in about three weeks from the commencement 
of the attack. In this case the stomach and bowels were mucli 
disordered previously to the occurrence of the erysipelas. 

In many instances, the disease is brought on by eating un- 
wholesome food. 

Treatment. — The most important indication for the cure of 
erysipelas, is to correct the disordered condition of the stomach 
and bowels. 

A Thomsonian course of medicine I have known in many in- 
stances to check at once the farther spread of the inflammationc 
Where the inflammation is on the face, the bowels should be re- 
lieved by an injection, before the emetic be given. In mild cases, 
and where the general health is not much impaired, the treat- 
ment may be correspondingly mild. An enema to evacuate the 
bowels, together with hot teas, to keep up a moderate perspira- 
tion, will be sufficient in the way of constitutional treatment, as 
long as the symptoms continue favourable. A wineglassful of 
lime water, adding half the quantity of boiled milk, given two 
or three times a day, may be taken to correct the secretions of 
the stomach. 

Where the countenance is sallow, indicating derangement of 



ERYSIPELAS — ST. ANTHONY'S FIRE, OR ROSE. 69 

the liver, or where the fever is high, or the patient much dis- 
tressed, the treatment should he more thorough. The enemas 
should he repeated occasionally, always containing a portion of 
lobelia. An emetic should be given as often as every day, in 
violent cases, and continue to give broken doses of lobelia, in 
composition or bayberry tea, or lobelia may be given in the 
form of pills. A teaspoonful of lobelia powder, given by injec- 
tion in warm water, and retained in the bowels, will in general 
relax the system more, and prove more serviceable than admin- 
istered in any other way. Free vomiting may often be effected 
in this way. In all severe cases it is important to keep the system 
more or less relaxed by small doses of lobelia; and likewise to give 
occasionally, either composition or pepper tea. The room should 
be kept of a moderate temperature. Very hot stove rooms are 
pernicious. 

The parts affected should be kept elevated, if practicable : — - 
thus, if on the face, the head must be raised higher than the 
body, or if on the limbs, they should be kept elevated, which fa- 
vours the return of the blood from the inflamed part. 

Of all means for the cure of erysipelas, emetics are the most 
effectual. Beside fulfilling other important indications, they 
have an influence in restoring the secretions of the liver. It is 
the opinion of some medical writers, that the liver is more or 
less diseased in all cases of erysipelas. Emetics may be given 
without previously administering the vapour bath, but where the 
inflammation is on the face, it will be proper to use the warm 
footbath, and an injection, previously to giving the emetic; and 
to continue warmth to the feet, by hot bricks wrapped in damp 
cloths. 

The Diet should be confined to the lightest kind of food, as 
slippery elm gruel, barley water, crust coffee, &c. In mild cases, 
or where the patient is on the recovery, more generous diet may 
be allowed, such as milk dishes, custards, boiled chicken, toast 
and tea, &c. 

"Where the attending fever is of a low typhoid character, with 
great prostration of strength, stupor, or low muttering delirium, 
and coldness of the extremities, active stimulants should be em- 
ployed. The remedy most to be relied upon in such cases, is 
the liquid of the third preparation of lobelia, in a strong tea of the 
bayberry or sumac. The dose to be of the usual quantity, and 
repeated at intervals of from two to four hours. This medicine 
will cause the patient occasionally to vomit, and the matter 
thrown from the stomach is generally of a very foul character, 
consisting chiefly of thick brown flakes of morbid secretions, 
which had previously coated the mucous membrane of the sto- 
mach, and which, if not removed, would continue to oppress the 



70 SHiNGliES. 

functions of that organ. I have witnessed recoveries under tliis 
mode of treatment, in various forms of disease where the symp- 
toms were such as are generally considered fatal. Beside the 
ahove remedy, the capsicum tea, carhonate of ammonia, Virginia 
snake root, wine whey, and essence of heef, may be employed 
to nourish and sustain the enfeebled forces of life. 

Local Applications — As a local application to the inflamed 
surface, the liquid part of the third preparation of lobelia has 
done well in all cases where I have employed it; for although a 
powerful stimulant, the patient generally has experienced less 
burning in the part than before its application. Soap liniment, 
opodeldoc, sweet oil and lime water, and tar ointment, may 
either of them be applied to the parts affected. There are some 
skins which all kinds of grease disagree with; — in such cases, a 
liniment would be improper. When the inflammation is on the 
limb, and the part remains swollen after the inflammatiO'n sub- 
sides, a bandage should be applied, commencing at the extremity 
of the limb, and bandaging upward. 

Where there is evidence of an accumulation of matter in the 
parts, deep incisions should be made in order to give the rpatter 
an early opportunity to escape. 

Children predisposed to erysipelas should not be vaccinated 
until the general health is restored. 

As a general rule, poultices do not answer a good effect in 
erysipelas, except wiien the parts ulcerate, or become gangre- 
nous; then the application of poultices maybe useful. In caseof 
simple ulceration, use a poultice composed of elm, ginger, pond 
lilly, and pounded cracker; but in case of gangrene, or mortifi- 
cation, the charcoal or yeast poultice will be more appropriate^ 



SECTION IX. 



SHINGLES. 



This form of disease is characterized by a cluster or band of 
blisters on an inflamed surface, commencing, in most instances, 
on the right side of the abdomen. In some instances this band 
of vesicles extends down to the groin, in others it passes upwards. 
It is very rare that this eruption occurs on the left side of the 
body. 

" This disease bears a very close resemblance to erysipelas,"*^ 



SHINGLES. n 

and arises from a disordered state of the system. *^ Loss of ap- 
petite, lassitude, slight headache, nausea, more or less fehrile 
irritation, together with scalding heat and tingling in the skin, 
and shooting pains through the chest and stomach, are the symp- 
toms which usually precede the eruption." 

The vesicles are transparent until the fourth or fifth day, when 
they acquire a yellowish or milky appearance, and in the course 
of a day or two break and form brown crusts, and in a few days 
after fall off. In some instances the skin ulcerates and leaves 
scars. 

Shingles very seldom attack any but young persons, and rare- 
ly, if ever, happen to children under three years of age. 

JVot dangerous* — Shingles are rarely dangerous. The erup- 
tion, however, occurring in a highly diseased or exhausted con- 
stitution, may be followed by dangerous consequences, from the 
supervention of gangrene. 

Treatment of Shingles, — Little need be said in relation to the 
treatment of this disorder. The same local applications may be 
«sed as recommended in erysipelas, and when the general health 
is much affected, an emetic to cleanse the stomach will be proper. 
Mild stimulants to promote perspiration, composition, ginger, 
pennyroyal, &c. If the bowels require attention, use enemas. 
Lime water with milk is good to correct the secretions, where 
the stools are acrid or of a greenish cast. 

The diet should be light, consisting of gruels, milk, toast and 
milk, elm gruel sweetened with loaf sugar, adding a portion of 
lemon juice. Cold drink in moderate quantities, may be allowed 
the patient, of which lemonade is generally the most grateful. 
When the bowels are costive, a gruel made of unbolted wheat 
flour, has a good effect 



SECTION X. 



SCALD HEAD. 

This name is given to a certain form of eruption which comes 
on the head. It commences with small ulcers which discharge 
a humour that forms into thick crusts or scales. In some in- 
stances nearly the whole of the scalp becomes affected, forming 
a continuous mass or scab, attended with paroxysms of intolera- 
ble itching ; and emitting an offensive odour. Sometimes the 
humour discharged is extremely acrid, producing an eruption 
w^herever it comes in contact with the skin, and in this way the 
disease not unfrequently spreads partly over the face, and extends 
down the neck to the back and shoulders. The glands about the 
ears are often swollen. 

Scald head is occasionally met with in adults, though it is 
very generally confined to children, and unless correctly treated 
may continue even for years. 

Treatment — The most important point in the treatment of 
scald head is the exclusion of air from the parts affected. To 
accomplish this, cut the hair off close, and apply Thomson's 
healing salve, or an ointment made of tar and suet; and put on 
a cap, either of bladder or of oiled silk. This will prevent the 
formation of scales, though the discharge of matter will continue 
until the parts heal. The cap should be taken off every day, and 
the parts that suppurate cleansed. By gently pressing a dry 
cloth on the parts, the pus will adhere to it, and in this way be 
removed. Then apply fresh ointment, and put on the cap, which 
should be rubbed over on the inside with tallow or oil, to prevent 
its adhering too closely to the salve or ointment. 

The head should never be wet with any kind of wash, except 
occasionally, when the itching is very annoying, which may 
sometimes be relieved by washing with a strong tea or tincture 
of bayberry or sumac. A strong tea made of common soot also 
answers a good purpose. 

Constitutional Treatment. — In bad cases a sweat and an emetic 
should be given every week or oftener, as the symptoms indicate. 
This will greatly facilitate the cure. Lobelia, given in small 
doses, is of especial benefit in all kinds of eruption. It may be 
given in pills, or in tincture, several times a day, in quantities 
merely sufficient to excite slight nausea. 



TETTEU. 73 

The composition powder, mixed with sugar and warm water, 
should be taken once or twice a day, more especially if the tongue 
be coated. The bayberry or sumac tea may be used for the same 
purpose. 

The spice bitters, or any other simple tonic may be used to 
strengthen digestion. 

Costiveness may generally be relieved by proper articles of 
diet, as stewed prunes, gruel made of unbolted flour, Avith the 
addition of a few raisins, stewed figs, rye mush, roasted apples, 
and ripe fruit in season. The diet, of course, is not to be con- 
fined to such articles exclusively. 

There is a scabby eruption that prevails among children gen- 
erally, commencing back of the ears, and frequently spreading 
over the cheeks, and on the head, resembling scald head. This 
eruption is to be treated the same as scald head: — apply the 
ointment to exclude the air, keep the parts dry, and restore the 
general health by appropriate constitutional treatment. 

The following preparation may be used in place of the exter^ 
ual application above-mentioned. 

Liver of sulphur, three drachms, 
Spanish soap, one drachm. 
Lime water, eight ounces. 
Rectified spirits of wine, ten drachms. 

To be mixed and melted together, and applied to the aifected 
parts night and morning. 



SECTION XI, 



TETTER, 



There are various forms of eruptions to which the name tet- 
ter is generally applied, all of which, however, depend chiefly 
upon a disordered state of the stomach and bowels, and require 
much the same kind of treatment. 

That which is termed dry tetter^ consists of red blotches on the 
skin covered with pimples, which itch very much. The erup« 
tion forms v/hite scales, like fine bran, which fall off; leaving the 
skin apparently healthy. The eruption reappears and repeats 
the same operation as before, and in this way will continue to 
disappear and reappear indefinitely. 

K 



74 TETTER. 

Pustular Tetter, — In this variety the eruption appears in clus- 
ters of small vessicles or blisters, containing at first a thin se- 
rum, which in a few days becomes yellowish, and breaking, form 
thin crusts or scabs, which fall off, leaving the skin in many in- 
stances in a healthy condition, except a slight degree of redness; 
occasionally the skin becomes excoriated. There is a sense of 
smarting, and sometimes pain attending the eruption. Not un- 
frequently the eruption reappears at intervals, and the disease 
this way may be prolonged for weeks or even months. 

Corroding, or Eating Tetter, as it is called, commences with 
small painful sores or ulcers, which soon spread into large spots 
of various forms and sizes, and discharge a thin watery humour. 
This humour is sometimes so acrid as to produce new sores 
wherever it comes in contact with the surrounding surface. This 
species of tetter is apt to spread rapidly and occasionally forms 
deep ulcers wliich are difficult to cure. 

There is another species of tetter, appearing in the form of 
hard, dry, red spots, usually about the size of a millet seed. 
This eruption is mostly observed on the face and neck, though 
in some instances, it extends over the whole body. Depending 
in general upon chronic derangement of some internal organ, es- 
pecially torpor of the liver, and obstinate constipation of the 
bowels, it not unfrequently becomes a seated disorder, and may be 
cured only by revolutionizing the constitutional efforts of the 
system. 

Treatment."— In some cases, the constitutional derangement or 
debility may be rectified by a change of habit. For instance, if 
the habits be sedentary, the patient should take exercise in the 
open air, especially after meals; and use especial care to keep 
the feet warm and dry. A change of residence from one part of 
the country to another, or from the city to the country, will, in 
many instances cure long standing complaints, where medicine, 
without change of residence, may fail. To regulate the bowels, 
which are generally costive where this kind of tetter exists, I 
have used the purified charcoal in composition, or spice bitter 
tea, with general success. The dose of the charcoal is a large 
teaspoonful three or four times a day. Two or three pills com- 
posed of lobelia and capsicum, taken at bed time, are useful also 
in regulating the bowels. The diet should be such as best suits 
the patient's constitution, avoiding, however, hot bread, sweet 
cakes, fat or salt meat, or strong coffee. Bread made of unbol- 
ted flour, is proper in all cases of costiveness. Washing or 
sponging the body occasionally with salt water, as soon as out 
of bed, and using friction to the skin with the flesh brush, or a dry 
salted towel, will give tone to the nervous system, and increase 



TETTER. 75 

the constitutional strength. The vapour hath, followed hy the 
shower bath, may be used when the patient is too chilly to bear 
the washing with cold salt w^ater alone. Exercise in the open 
air, cleanliness, and warm clothing, are of importance in all dis- 
orders of this kind. 

An occasional course of medicine and the free use of bitters 
to restore digestion, may be necessary in effecting a cure in obsti- 
nate cases of tetter. 

Treatment of the Dry Tetter. — There are various washes and 
ointments that may be used with benefit. The best, however, 
according to my experience, is a tincture of sumac berries in 
No. 6., or the third preparation of lobelia, to be applied fre- 
quently, and the parts anointed, especially at night, with 
Thomson's healing salve, tar ointment, or yellow dock oint- 
ment. 

If the patient require medicine, or if the eruption be not cured 
by the above applications, an emetic, or a course of medicine will 
be the surest means of effecting a cure. An occasional dose of 
composition may be sufficient to rectify the stomach and bowels 
in slight cases, or, what would be still better, a dose of the com- 
position powder, taken in a strong decoction of bayberry. 

Treatment of Pustular Tetter. — Salt water is a good wash in 
this and probably in other forms of tetter. The parts should be 
kept covered with salve or ointment spread on soft muslin or 
linen, and not exposed to the air except wiien necessary to w^ash 
and apply new dressings. Tetter may be found difficult to cure, 
unless protected from the air, and kept dry. 

The constitutional treatment should be the same as in the 
former variety. In fine there is no form of the disease in which 
the general Thomsonian remedies, such as composition, spice bit- 
ters, bayberry, or No. 3, &c., may not be used with advantage. 
Warm clothing, exercise in the open air, cleanliness, and a w^ell 
regulated diet, are of importance in all chronic diseases. 

Treatment of Eating or Corroding Tetter. — This variety of tet 
ter demands a more active course of treatment, especially w^here 
there is a tendency in the disease to spread rapidly. A full 
course of medicine should be given and followed by the usual sti- 
mulants and astringents, such as composition, ginger, capsicum 
and bayberry, in order to promote perspiration, and to correct 
the secretions of the stomach and bowels. 

The yeast poultice, or a compound of white pond lilly, elm and 
ginger, wet with a strong tea of raspberry leaves, to be applied 
to the parts affected, and renew^ed at proper intervals until the 



76 ITCH. 

ulcers assume a liealthy appearance, when the salve or ointment 
may be used as recommended in pustular tetter. 

There are various forms of eruptions of the nature of tetter^ 
all of which should be treated on the same general principles. 

In some instances tetter will spread over a considerable por- 
tion of the lower extremities, and sometimes over almost the 
whole of the body. A patient applied to me not long since, who 
had tetter over the whole surface of both legs, and the flesh was 
liard and swollen. The patient had been unable to sleep in bed 
for many months, on account of the tormenting itching, which 
came on at night, when covered in bed. 

The treatment, in such cases, should be to regulate the gen- 
eral health by the vapour bath, and emetics; together with the 
continued use of the compound lobelia pills, composition and 
spice bitters, and apply poultices made of elm, white pond lilly, 
and ginger; and after tlie parts run, and the swelling subsides, 
some simple salve may be applied: and cover the parts with silk 
oil cloth, in order to exclude the air. When it is necessary to 
cleanse the parts, the oil cloth must be again reapplied, and not 
permanently removed until the disease is entirely cured. 



SECTIOIV XII. 



ITCH. 



This disease, it is said^ is caused by an insect whicli pene-* 
trates the skin, and produces small vesicles or pustules, forming 
into scabs, and attended with an intolerable itching. 

The wrists, and between the fingers, are the parts affected, 
though occasionally it is observed on other joints, and on various 
parts of the body, excepting the face. 

Treatment — The sulphur ointment will cure the real itch, 
sooner, probably, than any othci' application. There are otlier 
remedies, which may be used with benefit, as frequently washing 
with salt water, or the preparation recommended by Dr. 
Thomson, which is spirits of turpentine, with about four times 
as much of No. 6: to be well shaken before applied. 



RING-WORM. 77 

Sulphur Ointment is made by rubbing together one ounce of 
the Jiour of sulphur, and four ounces of lard. This ointment is 
to be applied every night. It is recommended that a part of the 
body only be covered with the ointment at a time, — say one 
fourth. The addition of a few drops of the oil of lemon will 
conceal the disagreeable smell of the ointment. 



SECTION XIII. 



EING-WORM. 



Tais name is applied to an eruption consisting of vfery minute 
Vesicles, or blisters, closely compacted together, and which form 
a ring or circle. There is great diversity in the size of the ring, 
Varying from an eighth of an inch to two or three inches in 
diameter. In the centre of the larger rings, the skin is of its 
natural appearance. <*The eruption is always attended with a 
troublesome itching and tingling sensation." In four or five 
days the vesicles break, and form their crusts or scabs, wliich, 
in general, fall off by the eiglith or ninth day. In some in- 
stances, new circles of the eruption appear in succession for 
several weeks. 

Treatment, — Ring-worm may be readily cured in most in- 
stances, by washing the part with the tincture of lobelia, or the 
No. 6, and applying an ointment made of the narrow-leafed 
dock root, grated and stewed in lard. The meadow-fern oint- 
ment is also a good application. 

When the eruption proves obstinate under the above local ap- 
plication, it will be proper to use constitutional treatment. A 
dose of composition or spice bitters two or three times a day, or 
take a teacup half full of bayberry tea, and stir in it a teaspoon- 
ful of composition powder : sweeten, and take night and morn- 
ing. Lime w^ater in milk answers a good purpose, taken two 
or three times a day. A course of medicine, however, is the 
most effectual means of cleansing the system of all morbid hu- 
mours. 

An entire exclusion of air from ring-worm will mostly effect a 
cure in slight cases. 



SECTION XIT. 



CHAFING IN CHILDREN. 

Fat children are liable to cliafe about the neck, and other 
parts, where the skin of different parts comes in contact. 

Treatment — Apply scorched flour, or interpose a piece of 
muslin or linen slightly scorched, to absorb the secretions of the 
skin, which cause the excoriations. 

Where the buttocks become excoriated, or break out in sores 
from an acrid condition of the stools, apply some soothing lini- 
ment, as a mixture of lime water and sweet oil, and correct the 
secretions of the bowels by injections; and if the stomach be dis- 
ordered, give an emetic. The chalk mixture, or lime water, 
may be used with advantage, in correcting the acrid state of the 
secretions of the stomach and bowels. 



SECTION XV. 



PRICKLEY HEAT. 



Prickley Heat, as it is called, is caused by impurities in the 
blood, being thrown to the surface. Children are most liable to 
this eruption in very warm weather and during the period of 
teething. Derangement in the digestive powers are in almost 
every instance the original cause of the complaint. The erup- 
tion is mostly confined to the neck, breast and shoulders. 

Treatment. — A few doses of lime water, together with the use 
of the tincture of lobelia, in small quantities, merely sufficient to 
produce slight nausea, will, in general correct the derangement 
in the stomach and bowels. But the eruption will continue in 
many cases until the teeth are through the gums, and the irrita- 
tion has subsided. 

Loeal Application — Bayberry or sumac tea made very strong 
will allay the itching, adding a teaspoonful of the tincture of 



BRONCHITIS. 79 

lobelia, to an equal quantity of the bayberry tea, frequently ap- 
plied will cure the eruption. 

It sometimes happens that the eruption strikes in suddenly 
and the child becomes very sick, in which case an emetic of lo- 
belia in composition tea, will be proper, and injections adminis^ 
tered prepared in the same manner as the emetic. 



CHAPTER III. 
DISEASE OF THE CHEST JIJ^D LUJVGS. 

SECTION I. 



BRONCHITIS. 



The name bronchitis is applied to a disease of the lining 
membrane of the air vessels of the lungs and throat. It is a 
form of disease of very common occurrence, and is usually called 
catarrh or coldt either of which is a more appropriate term than 
bronchitis, which means an iiiflammation oi the &ro?ic/wa^ vessels, 
w^hereas tlie disease is not necessarily accompanied with inflam- 
mation, neither is it confined to the bronchial vessels. 

Sijmptoms, — This disease is greatly diversified, both in cha- 
racter and symptoms. Generally there is, in the first place, 
great lassitude, chilliness, loss of appetite, much oppression at 
the chest, the skin cold, the face pale, and the head heavy. The 
breathing becomes more or less sliort, and sometimes difficult. 
The cough is mostly slight at first, consisting of a mere hack, 
and, in some instances, dry; or the expectoration, in the com- 
mencement, is frothy or clear, and tough, like the white of an 
egg= In some instances there is no pain; in other cases, con- 
stant pain; and sometimes pain is only felt during the act of 
coughing. In most cases of bronchitis, there is more or less 
fever in the after part of tlie day, and a paroxysm of cougliing 
comes on at night. There islangour, headache, and dryness of 
the skin, and in some few cases, profuse perspiration. There is 



80 BRONCHITIS. 

usually more or less hoarseness, and a wheezing, or rattling 
breathing. 

In the young and plethoric, a strong reaction comes on early 
in the disease : the pulse is high; the countenance becomes 
flushed, and the breathing hurried. Whereas, in the aged and 
feeble, there is seldom much inflammation or fever, as the sys- 
tem is not able to establish and support an inflammatory action. 

" Infants are especially liable to this form of disease. In them 
the disease manifests itself by a short, quick, oppressed, and 
wheezing respiration; uneasiness on being placed in the recum- 
bent position; slight cough, somewhat hoarse at first, but humid 
and rattling as the disease advances; a uniformly pale, and anx- 
ious countenance, pulse frequent and tense; skin above the natu- 
ral temperature on the trunk, but the hands and feet are com- 
monly cool, or at the regular temperature." 

The disease, however, presents many grades of violence, both 
in the young and old. Sometimes the vital powers are in a 
sunken condition— there is low delirium, cold skin, weak pulse, 
blueness under the nails, and stupour. 

Sometimes there are paroxysms of difficult breathing, resem- 
bling that of asthma. 

Cause. — Cold and moisture operating upon debilitated frames. 
The disease occurring mostly in old persons and in weakly chil- 
drenr 

Fvvourable Signs. — Improvement in respiration, an easy ex- 
pectoration of a thick yellow matter, and more especially when 
the secretions of the 7iose are restored; the stools of a natural 
colour; and a general warmth and moisture of the skin. 

Unfavourable Symptoms. — Great distress and oppression, cold 
skin; little expectoration and ropy, like the whites of eggs; tend- 
ency to stupour or delirium, and a dry nose. These symptoms, 
most of which frequently attend the early stage, are not to be 
considered alarming, unless where they continue to exist in a 
later period of the disease. 

Bistinguishing feature between Catarrh and Bronchitis, — Ca- 
tarrh commences in the nose, and travels down, sometimes not 
reaching the lungs. Bronchitis begins in the lungs, and pro- 
ceeds up. 

Treatment. — Slight attacks of the disease, in general, require 
nothing more than an occasional dose of the composition or pep- 
per tea, with broken doses of lobelia; the use of a warm foot bath, 
and a strict attention to diet, and keeping the feet warm. 



BRONCHITIS. 81 

When the symptoms are more distressing, emetics will be pro- 
per : a full course of medicine is best in severe cases. The 
functions of the skin will be greatly assisted by the warm water 
bath, or vapour bath. 

Expectorants. — In the early stage of the disease, or as long as 
the cough is hard and dry, or tiie expectoration resembles the 
white of an egg, the patient should be kept slightly nauseated 
wuth lobelia, given in broken doses, either in the form of pills, 
tincture, or infusion. There are other articles which may be 
used to ease the cough, and promote expectoration, such as a tea 
of bran, flaxseed, elm, or liquorice root, acidulated with lemon 
juice, and sweetened with honey or rock candy; equal parts of 
olive oil, vinegar, and honey, stewed together, and taken fre- 
quently, in teaspoonful doses; onions or garlic sliced and covered 
with sugar, and kept moderately warm, form a syrup w^hich 
answers a good purpose, more especially in patients of weak 
nerves. Carbonate of ammonia, given in hot wine whey, will 
afford great relief in cases of extreme oppression of breathing. 
When the bowels are costive, injections should be used. Lobe- 
lia administered in this way, in simple luke-warm water, some- 
times excites an almost magic influence in equalizing the circu- 
lation, and counteracting the undue determination of blood to the 
lungs. The system kept under the influence of lobelia, the ex- 
pectoration soon assumes a favourable aspect, except in very 
stubborn cases. 



The Diet, in the early stage of the disease, should consist of 
light food, as barley water, tapioca, rice, sago, crust coffee, elm 
gruel, milk porridge, cScc. The expectoration becoming copious 
and yello^v, with other favourable symptoms, the patient may 
be allowed a more strengthening diet, as fresh beef, mutton, soft 
boiled eggs, stale bread, &c. 

The expectoration presenting a favourable appearance, and 
the secretions of the nose restored, the quantity of lobelia may 
be lessened, and three or four times a day the patient should take 
a teacup half full of strong bayberry or No. 3 tea, adding a tea- 
spoonful of composition powder, or half a teaspoonful of capsi- 
cum to t!ie tea, or the composition or pepper may be taken in 
the usual way. The spice bitters may be used as a substitute 
for the composition. 

An occasional emetic, or full course of medicine, will be proper 
at any stage of the complaint. Where the symptoms are violent, 
or tlie disease becomes protracted, a course of medicine will 
prove the most e.iectual. 

L 



82 BRONCHITIS. 

Balsam Copaiva is a valuable remedy in protracted cases of 
catarrh or bronchitis. The dose, for an adult, is from fifteen to 
twenty drops three times a day. It may be dropped on sugar, 
or rubbed up with a small portion of slippery elm powder and 
sugar, adding a few drops of some agreeable essence, and suffi- 
cient water to make it convenient to take. The modern plan of pre- 
paring the balsam in capsules, is a still better form for taking. 

The tinchire of myrrhy or Thomson^ s JVb. 6, may be used with 
benefit, more especially in the latter stage of the disease, and 
where the patient is affected with flatulency, or oppression at 
the stomach after meals, which is a proper time for taking it. 

J\*ight Stveats, — From the debility usually induced in pro- 
tracted cases of bronchitis, night sweats are apt to occur. Under 
these circumstances, the medicine at bed time should consist of 
a strong tea of the bayberry or No. 3, and in the morning, the 
surface bathed with No. 6 or pepper sauce, avoiding exposure to 
cold air. The clothing to be put on perfectly dry. A flannel 
garment wet with salt and vinegar, dried and worn next the skin, 
is recommended by some experienced physicians to check night 
sweats. The vapour bath I have found of benefit in preventing 
night sweats in some cases. Depending, however, upon debil- 
ity, it will be difficult, in many instances, to prevent night 
sweats until the system gains additional strength. 



CHRONIC BRONCHITIS. 

From repeated colds, unwholesome air, and improper diet| 
bad treatment, such as bleeding and active purging, confirmed 
dyspepsia, or other constitutional disorders; bronchitis is liable 
to become protracted for many weeks, or even many months, 
and to become a seated complaint. It then receives the name 
of chronic bronchitis. 

To describe all the various modifications of symptoms which 
attend chronic bronchitis, would be a task difficult to perform, 
and of but little practical utility. The disease appears in every 
grade of violence, from a slight affection, tothatof a deeply con- 
firmed, and sometimes incurable disease. A majority of the 
cases of consumption arise from neglected, or badly treated 
catarrh, or bronchitis. Clergymen are extremely liable to an 
affection of the throat which is usually called bronchitis, or the 
clergyman's sore throat. 

Symptoms in a %v ell-marked case of Chronic Bronchitis* — A 
troublesome cough, and free expectoration; general debility and 
wasting of the flesh; short, oppressed, and wheezing respiration; 



BRONCHITIS. 83 

paleness of the countenance, and blueness of the lips; chilliness 
in the early part of the day, followed by more or less hectic 
fever; night sweats, and extreme sensibility to cold; loss of ap- 
petite, with tenderness and distress at the pit of the stomach; 
and an unhealthy condition of the stools; more or less pain in 
the side or chest, particularly on coughing; and an inability to 
lie on one side. 

The symptoms, however, in chronic bronchitis vary accord- 
ingly as the character and circumstances of the case differ. 
Thus whilst in some cases the cough is frequent and harrassing; 
in others there is but little cough or raising, except in the 
morning. Night sweats and hectic fever, though common, do 
not always attend the complaint. The degree of derangement 
of the digestive powers varies greatly in different cases, and ex- 
erts a powerful influence over other important functions. In 
fine, it is upon the integrity of the stomach, that, in a great de- 
gree, depends the cure of the disease in the lungs and throaU 

Stone and glass cutters are peculiarly subject to affections of 
the air vessels of the lungs, from mechanical irritation kept up 
by inhaling particles of dust. 

Treatment — To correct the disordered stomach, promote di- 
gestion, and supply the lungs with fresh wholesome air, are 
especially indicated in the cure of chronic bronchitis. 

Thomson^s Course of Medicine is the most effectual means for 
cleansing the stomach and bowels; it also promotes the healthy 
functions of the skin, and the mucous membrane of the bronchial 
vessels. The course of medicine should be given as the circum- 
stances of the case require. A very good rule to be observed 
is, — that so long as the patient has an appetite, and is getting 
better, to omit the course. Morning is the best time for giving 
a course of medicine in chronic diseases. The skin should be 
bathed with some stimulant after the last batli in the course. 
An emetic in the morning before rising, the patient previously 
drinking some composition tea, will answer, in many instances, 
the place of a full course. The lobelia emetic to be prepared in 
bayberry or No. 3 tea. The simple No. 3 tea, made strong, 
will sometimes operate as an emetic, and afford much relief to 
the patient. 

From three to five of the No. 3 pills should be taken before 
meals, except when using Peruvian bark, or elixir of vitriol. 
The Peruvian bark, Colombo, Virginia snake root, wild cherry 
bark, gentian, spice bitters, Thomson's No. 4 bitters, should be 
given either singly or combined, where there is much debility 
and night sweats, and not confine the patient to a particular 
kind, but keep changing. I have used the elimr of vitriol with 



84 BRONCHITIS. 

decided benefit, in cases of night sweats; from fifteen to twenty 
drops may be given in a wineglass of a tea of Pjeruvian bark, or 
of some other tonic, and repeated three or four times a day. The 
bay berry or No. 3 should not be used at the time of using the 
Peruvian bark or elixir of vitriol. 

Fresh Mr. — In chronic bronchitis tlie patient should use 
moderate exercise in the open air as much as possible, with par- 
ticular attention to keep the body and feet protected from the 
cold. There is an instrument recently introduced into use, 
called a respiratory, by wearing which the patient can go out in 
severe cold weather, and experience no inconvenience in the 
lungs from the cold. Recoveries from this disease are greatly 
facilitated by fresh air. 

A change of residence, more particularly to a pine country, 
or to the sea board, provided salt air agrees with the patientj 
will, in many instances, prove of signal benefit. 

Vegetable Balsams,— These are sometimes found of especial 
benefit in cases of chronic disease of the bronchial mucous mem- 
brane. The balsam copaiva, balsam tolu, and Canada balsam, 
are those generally employed. The balsam copaiva is consi- 
dered the best; to be given at first in doses of from twenty to 
thirty drops, gradually increasing the quantity to fifty or sixty 
drops, and repeated three or four times a day. (The dose and 
mode of preparing the other balsams will be found in the Mate- 
ria Medica.) 

The bayberry or No. 3 in strong decoction, and adding a tea- 
spoonful of No. 6, or a small portion of pepper, should be given 
as often as once a day, where the tongue is coated. A very 
good mode of taking the bayberry is by rubbing the powder up 
with honey, and then adding a portion of luke-warm water, op 
what is better, a tea of aspin, poplar, or some other tonic. 
Powder taken without being scalded, will, in many instances, 
make more impression upon the stomach than when taken in de- 
coction. The No. 3 pills may be used in place of the above 
preparations, if the patient be averse to liquids. 

The purified charcoal may be used with advantage where the 
bowels are costive. 

Inhaling the smoke of cayenne pepper, though a harsh reme- 
dy, has in many instances been attended with the most signal 
benefit. It is applicable to cases of long standing. The proper 
mode of doing it is to put a small portion of cayenne pepper on 
a red hot shovel, the patient being covered with a blanket, to 
confine the smoke; or let the patient breathe the smoke whilst in 
a vapour bath. I recently met with a gentleman from Massa- 
chusetts who had been affected with a harassing cough, which 



CONSUMPTION^. 85 

continued for many months without any abatement, although lie 
had been under treatment in a Thomsonian infirmary. At length 
resorting to the inhaling of pepper smoke, his cough was cured 
in a few days. This gentleman described the effect of the smoke 
upon the lungs to be at first almost suffocating, and very dis- 
tressing, but in a short time the sense of suffocation passed off, 
perspiration became profuse, and the secretions from the eyes, 
nose, and mouth ran copiously during the operation. The secre- 
tions from the lungs, in a few hours after the first operation, 
changed their aspect, and were raised easily, and the mucous 
membrane was speedily restored to a healthy condition. 

Inhaling tlie fumes of tar is in some cases of benefit in re- 
storing a healthy action to the mucous membrane of the lungs 
and wind-pipe. Patients have also been cured of chronic bron- 
chitis by being exposed to the influence of oak bark dust. 

The External Applications proper for the chest are stimulating 
liniments; mustard poultices or plasters; or strengthening plas- 
ters. Cayenne pepper strewed on the plaster will often render 
it more efficient. 

Diet, — The most nourishing kinds of food should be used, as 
eggs, custards, stale wheat bread, and all kinds of wholesome 
articles that may suit the stomach. Meats are allowable, unless 
they be found to disagree with the stomach, avoiding veal, fresh 
pork, sausages, and all food fried in fat. A milk diet generally 
agrees with tlie patient, such as porridge, rice and milk, boiled 
milk and toast. Where the bowels are costive, a gruel made of 
unbolted wheat flour, or bread made of the same article should 
be used. 



SECTION II. 

PULMONARY CONSUMPTION. 

The lungs are liable to various forms of disease, producing 
different varieties of consumption. 

OF THE PRINCIPAI. VARIETIES OE CONSUMPTION. 

1st. Tubercular Consumption, — This variety of consumption 
commences with the formation of small roundish bodies (called 
tubercles) throughout the lungs; and as they increase in size, 
and suppurate, that part in which suppuration takes place is de- 
stroyed, or, its structure changed and rendered incapable of per- 
forming its natural function. 



86 CONSUMPTIOTf. 

TuhercleSj in tlie first place, are about the size of a millet seed, 
and generally are found in clusters or masses. There can be 
no doubt but that tubercles exist in the lungs of some persons for 
many years without increasing in size, or causing any consider- 
able inconvenience to the patient. 

Tubercular consumption prevails to a great extent in the Uni- 
ted States and in Great Britain, and is of all the varieties of 
consumption the most difficult to cure. This form of consump- 
tion occurs, almost exclusively, in scrofulous constitutions, or in 
persons of an hereditary tendency to tubercles. There are few 
cases of this form of consumption that commence in persons 
rising forty years old, the disease almost exclusively occurring 
between the age of fifteen and thirty. 

The Causes which usually bring on tubereular consumption in 
constitutions predisposed to the disease, are — repeated colds, or 
catarrhs; disordered stomach and bowels; sudden check of per- 
spiration after exhausting exercise; the introduction of antimony 
or mercury into the system;^ the intemperate use of spirituous 
liquors; copious bleeding; excessive venereal indulgence; con- 
finement in ill-ventilated apartments; and unwholesome food. 
If one or both parents be predisposed to scrofula, or tubercular 
consumption, all their children will be liable to pulmonary con- 
sumption; whilst in other instances, this hereditary disposition 
will exist in some of the children only; the rest being entirely 
exempt from it. Children are more apt to partake of the con- 
stitution of the mother than that of the father. There are in- 
stances^ however, where both parents have been consumptive, 
and all their children robust and healthy; and then, again, both 
parents may be healthy, and their children delicate and consump- 
tive. 

Sijmptoms. — Tubercular consumption commences with a short 
dry cough, which may continue for many months without expec- 
toration, except of small portions of glary mucous. The 
breathing short and oppressed, with a sense of tightness or un- 
easiness in some portion of the breast whilst taking a full inspi- 
ration. There is much debility, and a gradual wasting of the 
flesh; the appetite fails and the digestion is impaired, and the 
patient is very liable to have a catarrh on the slightest exposure 
to cold or damp air. 

As the disease progresses emaciation and debility increase; 
the cough becomes more harassing, and the breathing shorter 
and more oppressed; night sweats occur, which leave the pa- 

* Tubercles have been produced in the lungs of animals by giving them mer- 
cury by way of experiment. 



CONSUMPTION. S7 

tient in an extremely languid condition. There is chilliness in 
the fore part of the day, followed hy a flush on one or both 
cheeks, and a burning in the palms of tlie hands and soles of the 
feet. The tongue is usually coated with a thin white fur, or 
sometimes clean and of a pale pink colour. 

Sooner or later in the disease the tuberculous masses become 
softened into the consistency of pus, and portions of the suppu- 
rated matter are discharged into the air vessels, and coughed up 
in tlie form of a thick yellow-like or greenish matter, assuming 
the character of genuine pus, and frequently streaked with blood. 
When this change in the character of the expectoration occurs, 
the cough, in some instances, becomes less distressing, but the 
general weakness increases, the flesh continues to waste, night 
sweats become more profuse, and usually there is a slight chill 
in the morning and towards evening. After the evening chill, 
liectic fever comes on, during which the pulse is seldom less than 
120 per minute. In the absence of fever the pulse is soft, lan- 
guid, and weak. As the disease advances, the expression of the 
countenance becomes changed, the eyes assume a pearly white- 
ness; the voice becomes weak and hoarse, or hollow; the feet 
swell, and a diarrhoea comes on, accompanied with rapid ex- 
haustion; the mind is in many instances free from depression; 
and but little impaired until near the termination of the disease, 
when there is apt to be some degree of delirium, and ^^occasion- 
ally total imbecility about a week previous to death." 

Of other Modifications of Symptoms* — In some instances tuber- 
cular consumption runs its course witli scarcely any prominent 
symptom of disease in the lungs, — there being no pain or difli- 
culty of breathing, and but little cough or expectoration. There 
is a general wasting of the flesh; night sweats; failing of the 
appetite; the countenance is pale, and the flesh soft and flabby. 
Frequently, in these cases, there is more or less blood raised, 
and sometimes the lungs bleed freely. As the disease advances, 
however, tlie cough becomes more troublesome, witli frequent 
inclination to vomit, and a rapid wasting of flesh and strength. 
The bowels are generally either much constipated, or relaxed; 
the nose becomes pointed and cold; the lips pallid or blueish; 
and the expression of the countenance is changed. 

2d. Bronchial Consumption, — A variety of consumption which 
probably occurs next in frequency to the one just described, is 
seated in the mucous membrane of the air passages of the lungs 
and wind-pipe. Chronic bronchitis is the term usually applied to 
this form of disease, and which from old age, bad digestion, 
neglect, or improper treatment, is apt to terminate in confirmed 
consumption. This form of disease is mostly confined to chil- 



88 CONSUMPTION. 

dren, and to the aged. The general character, symptoms, and 
treatment are described under the head oi chronic bronchitis. The 
great majority of the ciired cases of consumption have been of 
this variety. 

In some instances chronic bronchitis accompanies tuberculous 
consumption, the two forms of disease being blendedr 

3d. Consumption consequent on Pleurisy, — From bad treatment, 
or under unfavourable circumstances, pleurisy is occasionally 
followed by the formation of an abscess in the chest, which is apt 
to produce ulceration of the lungs and thus cause pulmonary 
consumption. 

The Symptoms which characterize abscess in the chest, are 
cough and difficulty of respiration ; a sense of oppression or load 
in the chest on lying down; more or less pain and tenderness to 
pressure in the aifccted side; and above all, a dull sound given 
by percussion on the chest. These symptoms, together with the 
previous existence of pleurisy, will serve to distinguish the dis- 
ease. 

Sometimes the abscess ulcerates through the lungs into the air 
vessels, and is discharged by coughing. There are night sweats, 
hectic fever, and wasting of flesh and strength. After the ab- 
scess is in this way discharged, the patient may experience a mi- 
tigation of his sufferings, and occasionally there are recoveries; 
but more frequently the disease terminates fatally, and sometimes 
death suddenly takes place. 

4th. Throat Consumption. — Tliis variety of consumption con- 
sists of ulceration of the throat and wind-pipe. It is usually 
rapid in its course, and when fully seated before proper treat- 
ment is applied, it is mostly fatal. 

Cause. — Throat consumption is generally brought on by the 
neglect of repeated colds. Sometimes it follows measles and 
whooping cough. 

Symptoms. — In the first place there is derangement of the 
general health, such as want of appetite, feeble digestion, cold 
and torpid bowels, a diminished temperature of the body, and 
extreme sensibility to cold. There is uneasiness and pain in the 
wind-pipe, which is increased by coughing; the patient frequent- 
ly puts his hand to the throat, in consequence of the uneasy sen- 
sation in that part. The voice sooner or later becomes changed 
to a hoarse and feeble whisper. More or less pain is experi- 
enced in the throat on ** bending the head backwards, or on 
turning it round." The cough is apt to be severe in the morn- 



CONSUMPTION. 89 

Ing, and is almost always brought on by attempting to swallow. 
The expectoration is slight, in some instances, and in others it 
is copious. 

When the disease is fully established, the countenance becomes 
pale, and the skin sallow; the ilesh wastes rapidly, with chilli- 
ness followed by hectic fever towards evenings and profuse sweat- 
ing during sleep; the mind is dejected and irritable, and there 
is a haggard expression of countenance. 

There are cases in which the voice becomes indistinct, or en- 
tirely lost, in catarrhal affections, and the patient continues to 
enjoy good health. 

Treatment of Consumption, — In tubercular consumption, even 
Thomsonian treatment, unless applied very early in the com- 
plaint, and under favourable circumstances, will seldom effect 
more than a mitigation of the symptoms, and in some degree 
checks the progress of the disease. There can be no doubt, how- 
ever, that in some instances where tubercles exist in the lungs, 
that by strict attention to the preservation of the general health, 
and a judicious use of medicine, when required, that these tuber- 
cles may continue for many years without being farther devel- 
oped, and even permit the patient to live to an old age. 

The general indications of treatment are — to correct the sto- 
mach and bowels with an occasional covrse of medicine; to pro- 
mote the secretions by a continued use of lobelia in broken doses; 
to sustain the circulation, and maintain a determination to the 
surface by the use of pure stimulants, such as capsicum and com- 
position, assisted by an occasional vapour batli; together with 
frictions on tiie surface with the flesh brush, horse-hair mits, or 
salted towel; stimulants to the skin, as pepper sauce, or stimu- 
lating ointments ; and warming plasters on the breast, or between 
the shoulders. 

Fresh Air. — In the early stage of consumption the patient 
should seek the open air as much as possible, or at least should 
avoid small and tight rooms. Where a stove is used to warm a 
room, there should be a basin of water kept on it constantly, to 
prevent too much dryness. In severely cold weather, patients 
may take the air, wearing over the mouth the instrument called 
a respiratory which being kept warm by the breath, increases the 
temperature of the air that passes inwardly, and thus renders it 
more suitable for weak lungs. 

Rmnadge^s Tube, — Of the utility of this instrument in the cure 
of consumption, I cannot speak from my own experience or ob^ 
servation, the practice having been but recently introduced. But 
from the testimony of those who have made repeated trials of it, 

M 



90 CONSUMPTION. 

I cannot doubt of its utility in the early stage of tubercular con- 
sumption, and more especially as a means of preventing consump- 
tion in those who are predisposed to the disease. 

The Rev. Mr. Howe, who first introduced tliis tube into use in 
this country, asserts that the use of the instrument a few months 
will occasion so great an expansion of the chest and lungs, as 
to enable the patient to take in double the quantity of air than 
before using it. If its effects be such as are here stated, it will 
constitute at least one of the surest means of preventing tubercu- 
lar consumption. 

The construction of the Ramadge tube is such as to admit 
only a very small quantity of air at once, which occasions the 
patient to use considerable effort in order to get a supply of air 
to the lungs. The breath is then to be forced out through the 
tube which again requires extra exertion on the part of the mus- 
cles of the chest; and the retention of the air in the lungs it is 
said will occasion the gradual enlargement of them. The use 
of this tube w^ould be injurious in the latter stage of consumption, 
or where the heart is diseased. 

Tubercular consumption is generally incurable, yet there are 
instances in which, after the tubercular matter is discharged, the 
cavity in the lungs becomes cicatrized, and the patient is restored 
to health. 

Treatment of Bronchial Consumption,— The character and 
symptoms of this form of disease are described under the head 
of chronic bronchitis. A vast majority of the cured cases of 
consumption have been of this variety, — the disease being seated 
in the mucous membrane of the bronchial vessels. This disease, 
though greatly under the control of medical treatment, under un- 
favourable circumstances may prove incurable. Thus w^hen 
it occurs in persons far advanced in life; or when the constitu- 
tion is vitiated by intemperance. 

Confinement in the foul air of ill- ventilated apartments; an 
unwholesome diet; and frequent careless exposure of the feet to 
dampness, are also unfavourable to the cure of the disease. 

The course of treatment laid down for chronic bronchitis, will 
be proper in this variety of consumption, the latter being an ag- 
gravated or long continued disease of the mucous membrane of 
the bronchial vessels. 

Tlie coiirse of medicine must be repeated at proper intervals, as 
the symptoms demand. Preparations of lobelia — the tincture or 
pills — taken in small doses, and repeated several times a day. 
AYhere the expectoration is profuse, bitters sliould be taken to 
assist digestion and sustain the strength, and not confine the 
patient to any one preparation of tonics, but occasionally change 
them. 



CONSUMPTION^. 91 

The No. 3 pills should he taken at hed time, in the place of a 
d-ecoction of hayberry, where there are night sweats. In case 
liquids oppress the patient, all medicines may be given in the 
form of pills. Quinine is a good tonic, and is very readily 
made into pills; the No. 3 pills form a substitute for the bay- 
berry tea; and the lobelia and capsicum may also be given in 
pills. It must be recollected that the No. 3 pills and quinine 
should not be given at the same time : one of them, however, 
may be used in the fore noon, and the other in the evening. The 
conserve of hollyhock may be used as a mild stimulant, tonic, 
and expectorant. 

Inhaling the smoke of burning pepper, unless the case be very 
deeply seated, promises much in the cure of this form of con- 
sumption. 

For directions in relation to diet and regimen, and the use of 
balsamic and other remedies, the reader is referred to the treat- 
ment of chronic bronchitis. 

In Consumption from Chronic Pleurisy, the same general plan 
of treatment should be adopted as in the former varieties, namely, 
— to cleanse the stomach and bowels, and promote a healthy ac- 
tion of the general system by an occasional course of medicine; 
broken doses of lobelia as an expectorant, and also to lessen mor- 
bid excitement; the No. 3 pills, or a strong decoction of bay- 
berry once or twice a day to prevent the accumulation of morbid 
secretions on the mucous coat of the stomach; the vapour bath 
to i^romote the action of the skin, and assist in equalizing the 
circulation; stimulants and tonics to restore and sustain the di- 
gestive and nutritive functions; and injections to relieve the 
bowels when required. In this form of consumption, or where 
there is evidence of an abscess in the chest, to inhale the pepper 
smoke v/ould be of doubtful utility. 

Throat Consumption requires a plan of treatment similar to 
that required in chronic broncliitis. 

Persons experienced in sounding the chest with the stether- 
scope, and by percussion, may sometimes form by these means, 
a pretty accurate judgment of the character and extent of dis- 
ease of the lungs. As this method, however, requires long ex- 
perience and much tact, in order to distinguish by it the charac- 
ter of the disease, it will be useless to recommend it in a family 
w^ork, more especially as it is of no utility in the cure. 

As the same general or constitutional treatment may be ap- 
plied with safety to all diseases of the chest, any anxiety on the 
part of the patient, or friends, or practitioner, respecting the pe- 
culiar forms which these diseases may assume, maybe dispensed 
with, and these general directions with regard to the treatment 



92 ASTHMA, OR PHTHISIC. 

persisted in. Even diseases of the heart have been cured by 
Thomsonian courses of medicine, with proper attention to diet 
and regimen. 



SECTION III. 



ASTHMA, OR PHTHISIC, 

Asthma is a disease of the organs of respiration, generally 
occurring in fits, or paroxysms. 

In some persons, the predisposition to asthma is induced. In 
others it is hereditary^ beginning its attacks in childhood, and 
occurring at intervals through the whole course of a long 
life. Sometimes children will be affected with phthisic for a few 
years, and as they advance in age, become entirely free from its 
attacks. Although asthma may occur at any age, still those who 
are past the meredian of life are most liable to it. 

The Season of the year in which Mthma occurs, varies in dif- 
ferent individuals. Thus whilst in some the attacks are princi- 
pally confined to cold and damp weather, others are only liable 
to it during mid^summer. Others again may have it during any 
season. 

Causes. — Asthma is in general a disease of enervation,— a 
deficiency of the nervous power which governs the function of 
respiration. Hence it may be brought on in a person predis- 
posed to the disease, by any cause that tends to weaken or im- 
pair the nervous influence, such as exposure to cold and damp- 
ness; inaccuracies in diet; over exercise or fatigue; venereal 
excesses; and certain electric conditions of the atmosphere. The 
disease, in the great majority of instances, is associated with 
feebleness of digestion. Absence of day-light depresses the ner- 
vous powers, and this will explain the cause why the disease 
generally comes on at night, and subsides on the approach of 
daij-light. 

Asthma, in some instances, arises from organic disease of the 
heart. In other instances, a mere functional derangement of the 
circulating organs, will occasion an attack; and on the other 
liand, an attack of asthma will be attended by palpitations of 
the heart, which entirely subside as the paroxysm of asthma 



ASTHMA, OR PHTHISIC. 93 

passes off. Asthma may be considered in general as a secondary 
affection, the primary seat of the disease being in the stomach. 

J^ot a Fatal Disease, — Asthma seldom jjroves fatal, though in 
some cases it is extremely difficult to cure. When connected 
with organic disease of the heart, it may prove fatal at any 
time. 

Symptoms.-^AsihmsL is characterized by a sense of tightness 
across the chest, great difficulty of breathing, and a distressing 
sense of suffocation. It is seldom accompanied by fever. 

An attack of this disease is generally preceded by a sense of 
weight and fulness at the pit of the stomach, and eructations, 
heartburn, flatulency, weight over the eyes, and itching of the 
skin. When the paroxysm comes on during sleep, tlie patient 
is apt to have frightful dreams, and to wake up in great distress, 
w^ith a sense of tightness through the breast, great difficulty of 
breathing, and a short dry cough. *^ These symptoms soon ac- 
quire a most appalling degree of violence. The breathing be- 
comes wheezing, extremely laborious, gasping and suffocative; 
the countenance is expressive of intense anxiety and distress, and 
the heart usually palpitates violently. The desire for fresh air 
in very violent cases, is inexpressibly urgent; the patient insists 
on the doors and windows being thrown open; and is totally un- 
able to remain in a recumbent posture. The extremities are 
generally cold and the skin moist and clammy; the face is bloated 
and livid, or pale, and the veins of the neck hard and turgid. 
After these symptoms have continued for an indefinite time, the 
breathing becomes less laborious and anxious, and towards morn- 
ing a copious expectoration of viscid mucous generally ensues, 
which always brings with it considerable relief. During the 
ensuing day the patient usually feels but little oppression or un- 
easiness in the chest. On the next night, however, the paroxysm 
of suffocative respiration returns; and in this way the disease 
proceeds, with remissions by day and exacerbations by night for 
three or four days in succession, and in some instances much 
longer, before it finally subsides." 

Paroxysms of asthma may occur at any period of the day or 
night, though they usually come after midnight. In some in- 
stances they continue without any complete intermissions of the 
difficult breathing, for several days or even weeks, but ahvays 
worse at night. 

Treatment of Asthma — In many instances, where the attack 
is slight, the tincture of lobelia given in composition or pepper 
tea, and placing the feet in warm mustard water, will be suffi- 



94 ASTHMA, OR PHTHISIC. 

cieiit to afford great relief, and sometimes will overcome tlie 
symptoms. 

The Vapour Bath. — I liave found tlie vapour bath not only to 
assist in breaking up paroxysms of asthma, but in many cases 
almost indispensable, as the emetic in some instances will not 
operate previously to the vapour bath being administered. 

The Hot Mr Bath from Burning Mcohol. — When the skin is 
Cool and inclined to moisture, the hot air bath will answer as well 
and be attended with much less trouble than the steam bath, more 
especially in hot weather, when fire is not required in sick 
rooms. 

The stimulating liniment, pepper sauce, or No. 6, should be 
applied over the surface after the bath. Previously to applying 
the stimulant to the surface, let the patient be showered, or 
washed over with spirits or vinegar, and then rubbed dry. 

Emetics. — These are the most effectual means for the cure of 
asthma. To prepare an emetic infuse the brown lobelia in a 
strong decoction of bayherry tea, the patient having taken pre- 
viously of pepper or composition tea, or let some capsicum be 
added to the emetic; this should be taken in the usual doses and 
repeated as often as necessary. The more the patient becomes 
relaxed the greater in general will be the relief. In place of the 
above compound, the liquid of the third preparation of lobelia 
may be used for the emetic, or a combination of the lobelia pow- 
der with the third preparation. 

Jl Course of Medicine given in the evening, or before tlie time 
the asthma comes on, or as soon as the first symptoms arise in- 
dicating its approach, will in general, keep off the paroxysm, or 
at least greatly moderate its violence. The tincture of lobelia 
will often fail in bad cases of making sufilcient impression on the 
stomach; but the brown powder or the third preparation I never 
knew to fail in relieving the most severe paroxysms of asthma. 

Injections, — are important in the treatment of asthma, and in 
some instances will afford instant relief. Lobelia administered 
in this w^ay and retained, will relax the system as effectually as 
when taken into the stomach, and generally will excite free vo- 
miting. 

The Skunk Cabbage answers a good purpose in many cases of 
asthma, though in general far inferior to lobelia. 



ASTHMA, OR PHTHISIC. 95 

Treatment during the remission or interval between the parox- 
ysms. — Broken doses of lobelia, either in tincture or tlie com- 
pound lobelia pills, together with an occasional dose of composi- 
tion or pepper, will often be sufficient. Where the disease be- 
comes protracted, liowever, and the system is in a feeble condi- 
tion, tonics will be useful. Bonesett tea, taken cold, I have found 
to be decidedly useful in some cases. Tlie scutilaria or scull 
cap, may be used as a tonic, and answers as a nervine. 

English Garlic operates as a stimulant on the nervous system, 
and is therefore well adapted to cases of asthma, more especially 
where the disease being protracted, requires occasionally a 
change in the medicine. Let the patient cliew and swallow a 
clove of tlie garlic every morning before breakfast. 

Stimnlating applications to the surface. — In asthma the skin 
is usually below its natural temperature, and inclined to mois- 
ture. Where this condition of the skin prevails, the stimulating 
liniment, the No. 6, or pepper sauce, should be applied over the 
surface before going to bed. A plaster of the stimulating lini- 
ment spread over a piece of bladder or silk oilcloth, and bound 
on the pit of the stomach, will have a tendency to prevent the 
occurrence of the paroxysm. The same application may also be 
applied to the soles of the feet. 

Biet. — The first symptoms, in many instances, on the approach 
of an attack of asthma, are, an unpleasant sense of weight, or 
stricture, and coldness at the pit of the stomach; and this fre- 
quently occurs soon after eating. The stomach not being able to 
digest what had been taken, is oppressed, and asthma follows as 
a consequence of that condition of this great central organ. As 
long as the patient is liable to the attacks, especial care should 
be observed to avoid any article of difficult digestion, more espe- 
cially at the evening meal. Where the patient craves acids, the 
pepper sauce, or lemon juice and sugar will frequently be grate- 
ful to the stomach, and favour expectoration. 

Jt Cold Shower Bath every morning, by giving tone and vigour 
to the nervous system, will often prove especially useful in asthma, 
more particularly in hot weather. It may also prove a preven- 
tive to the disease. A dash of cold vinegar upon the breast will 
sometimes afford i^elief during the paroxysm, by producing reac- 
tion. 



■1 



SECTION IV. 



SUMMER CATARRH, OR COLD—HAY FEVER. 

There is a catarrhal affection of the mucous membrane, ex- 
tending from the nose to the lungs, which comes on in warm 
weather, and in some persons it occurs periodically every sum- 
mer. It is a disease of enervation ; consisting essentially in de- 
ficiency of nervous energij. 

The dust from fresh dried hay is very apt to bring on the dis- 
ease in those predisposed to it, and from this circumstance it is 
in some places called '^ hay fever/' Other kinds of dust, how- 
ever, will have the same effect. 

In some delicate persons the slightest exposure to cold or 
damp air, will occasion catarrh. Dr. J. K. Mitchel mentions 
the case of a female who would invariably be siezed with a ca- 
tarrh from taking hold of a tumbler of cold water. 

Sijmptoms, — At first there are symptoms of indigestion, and a 
sense of fulness in the head. There is watering of the eyes, and 
the nose discharges copiously of a thin secretion. A cough gen- 
erally comes on, and an expectoration resembling that which 
attends ordinary colds. 

Treatment. — Tonics are particularly indicated. Colombo, 
gentian, Virginia snake root, barberry, xanthoxylum, balmony, 
and poplar, may either or all be employed. 

If the tongue be coated, or there be other symptoms of a foul 
stomach, a strong decoction of the bayberry should be taken as 
often as once a day, and if this be ineffectual an emetic may be 
administered. The surface of the body should be bathed occa- 
sionally with some stimulant, as pepper sauce, or No. 6. 

As a preventive use the shower bath, or sponge the body Avith 
cold water every morning for a few weeks before the time at 
which the disease usually comes on. 



SECTION V. 



WHOOPING-COUGH. 

This disease is contagious, and T)ccurs but once in the same 
individual. It is almost exclusively confined to childhood, and 
generally prevails as an epidemic. 

This, like most contagious diseases, runs a certain course, or 
succession of stages, constituting its " rise, progress, and declen- 
sion." In some instances, however, the disease may be cut 
short by medicine. 

Whooping-cough is seldom fatal, except when under unfavour- 
able circumstances, as in weak and delicate infants a few months 
old, or when it attacks children of scrofulous constitutions* 
Under these circumstances it is liable to be followed by con-- 
sumption, or other forms of disease of serious character. Where 
the disease commences in the autumn, the cough is apt to con- 
tinue until the succeeding summer. 

Symptoms.— -The disease commences like an ordinary cold or 
catarrh, with languor, sneezing, hoarseness, cough, and occa^ 
sionally oppression in breathing. The bowels are costive, the 
appetite bad, and digestion impaired. The tongue is mostly 
contracted, and pointed, and of a darker colour than it naturally 
is, and in most instances nearly clean, or very slightly coated. 
The cough is mostly dry during the first three weeks. 

About the end of the third week the spells of coughing con- 
tinue longer, tliey are more severe, and are attended by the pe= 
culiar sound called whooping. During the paroxysm of cough- 
ing the patient can scarcely get breath, occasioning a distressing 
sensation of suffocation, and the face becomes suffused with blood« 
The fit of coughing may last from half a minute or less, to four 
or five, or even ten minutes. Usually^ after the third week from 
the commencement, there is a copious disciiarge of a viscid mu- 
cous, after a spell of coughing. Sometimes vomiting occurs 
whilst coughing, which frequently affords great relief to the pa- 
tient. In very aggravated cases, children are sometimes thrown 
into convulsion fits, from congestion of blood in the brain, occa- 
sioned by the violence of coughing, and the suspension of breath- 
ing during the paroxysm. 

After the expectoration continues free for a week or two, the 
paroxysms of coughing in many instances begin to decline both 
in frequency and violence; whereas in other cases the disease 

N 



^8 WHOOPING-COtGH. 

continues for six or eight weeks before there is any abatement in 
the violence of the cough. 

Treatment of Whooping- CougJu-— Throughout the entire 
course of the disease the treatment should be regulated in ac- 
cordance with the nature of the <:ase. Nauseating doses of lobe- 
lia promote expectoration— generally relieve the cough — quiet 
restlessness, and promote the secretions of the skin. In bad 
cases, where the breathing is Wiudi oppressed, or the patient is 
very restless, an emetic will be proper. The vapour bath will 
assist the operation of the emetic. A course of medicine will i^i 
some instances cut short the disease. 

Injections must be used where the bowels are costive, or other- 
wise disordered. Lobelia administered in this way, in luke- 
warm water, and retained ten or fifteen minutes, will have a 
decidedly beneficial effect, especially where there is an undue 
determination to the head or lungs. Under its influence th^ 
circulation becomes more equalized; the system becomes relaxed; 
and very often free vomiting is produced. 

In the more advanced stage of the disease, where the secre- 
tions become profuse, attended witfi severe fits of coughing, 
which come on periodically, an emetic or an injection, as above 
described, administered previously to the time at which the 
paroxysms of coughing commonly occur, will mitigate the cough 
and favour the expulsion of the viscid mucous from the lungs. 

Cough Medicines. — Liquorice-root tea; flaxseed tea, with 
lemon juice; a mixture of honey with sweet oil; onion or garlic 
syrup, are all good for the cough. The tincture or syrup of lobelia, 
however, is the best expectorant, and may be used in combina- 
tion with any of the above-named articles. 

\Yhere convulsion fits occur, the third preparation of lobelia 
should be given, either alone or in bayberry tea, and injections 
administered. In giving lobelia as an emetic, in ordinary cases, 
it should be prepared in bayberry or composition tea. 

Stimulants are more particularly indicated in the advanced 
stage of the disease, where the appetite is bad, and the system 
in a feeble condition. A small portion of the composition pow- 
der in a wineglass of bayberry tea, and administered once or 
twice a day, will cleanse the mucous membrane of the stomach, 
and also furnish a stimulous to the vital powers of the system. 

It sometimes happens that the cough is protracted as a conse- 
quence of a want of vital power. In such cases tonics should be 
used, such as spice bitters, Virginia snake root, chamomile, 
Colombo, &c. 



FLEtTRIST. 99 

The Cold Bath, if the patient remain in a feeble condition, 
after the whooping-cough, will have a signal influence in toning 
the system. It is safer to commence with the tepid bath, with 
the water at about 90 degrees, and gradually diminish the tem- 
perature as the patient can bear it. The patient should be sud- 
denly dipped, or showered, and immediately rubbed dry, and 
"wrapped in a warm blanket. The proper time for administering 
the bath is in the morning. 

Change of Mr, — To move from the city to the country, or from 
the country to the city; or even a change of residence in the same 
neighbourhood, will sometimes speedily cure the lingering cough, 
and debility, which is apt to follow w hooping-cough. 



SECTION VI» 



PLEURISY. 



Pleurisy is an inflammation of the membrane that lines the 
internal surface of the chest, which is called the pleura. This 
membrane also forms the external coating of the lungs. 

Any portion of the pleura is liable to become diseased, but that 
on the right side is more commonly affected. 

It is asserted by medical authors that pleurisy mostly attacks 
the robust and plethoric, but under my own observation the dis- 
ease has occurred almost exclusively in the dyspeptic, the feeble, 
or the intemperate. 

Under Thomsonian treatment, pleurisy is seldom fatal, unless 
complicated with extensive derangement of some important 
organ; or when it attacks age or debility, or vitiated constitu- 
tions. 

Causes. — Exposure to w^et and cold; sitting in a current of 
air, or in a cold room, after severe fatiguing exercise, or sleeping 
in damp sheets, are common causes of pleurisy. Persons are 
often liable to be attacked with the disease after severe surgical 
operations. 

Symptoms. — An acute or lancinating pain in the side of the 
chest; hurried and painful breathing; a short dry cough, or 
attended with slight expectoration of a glary and almost colour- 
less phlegm, are the symptoms wiiich characterize pleurisy. 



100 fXiEtillSY* 

The pulse in general is hard and frequent; the face flushed; the 
tongue coated; the skin dry and hot; and the urine scanty and 
high coloured. 

The symptoms, however, in this, as in other forms of disease, 
are modified by the various circumstances under which the dis- 
ease may occur, as the age of the patient, the strength of the 
constitution, the extent of derangement of important organs, es- 
pecially of the stomach and liver; or the degree of susceptibility 
of the lungs to become affected. Thus in the young and vigour- 
ous tlie reaction is apt to be strong, whilst in the aged and fee- 
hie the countenance may remain pale, and the pulse weak. In 
some cases the breathing is greatly oppressed, whilst in others 
there is but little oppression, and no pain. The cough, which 
is usually harassing, is almost wanting in some instances* The 
expectoration, though in general colourless in the commence- 
ment, is occasionally tinged with blood, from the first, and 
"when the disease extends to the substance of the lungs, the ex^ 
pectoration is mostly copious, and consists of a ropy mucous^ 
mixed with blood* The condition of the stomach modifies also 
the character of the symptoms, and influences, to a great degree, 
Loth the violence and tlie duration of the disease. The liver 
being torpid, or the flow of bile obstructed, the skin and eyes 
become yellow, or the countenance presents an appearance of 
a '^sickly mixture of red and yellow.'^ 

Inflammation of the pleura is very liable to produce adhesions 
between the side of the chest and lung, an occurrence, however, 
not productive of danger, and seldom of much inconvenience. 
But under unfavourable circumstances, an abscess is sometimes 
formed, which is always attended with more or less hazard to the 
patient. 

Favourable Signs. — A free expectoration of a thick yellow 
matter; an increased flow of urine, which on standing deposits a 
sediment; a general and warm perspiration, together with an 
abatement of the pain and oppression, indicate a favourable ter- 
mination of the disease. 

The unfavourable signs are, an increase of pain and oppress 
sion; the cough continuing dry, or the expectoration resembling 
a dirty mixture of blood and water; a sense of suffocation, and 
a sudden raising up in bed, or a ^' constant effort by the patient 
to bare the breast and to raise his head and shoulders; a w^eak 
and irregular pulse; a livid appearance of the lips and counte- 
nance; a sense of burning on the surface and coldness internally, 
together with a rattling in breathing, and a tendency to deli- 
I'ium or stupour. These symptoms though indicative of great 
danger, should not be considered as necessarily of fatal omen. 



PLEUHISY. 101 

for recoveries occasionally happen after symptoms of the most 
alarming cliaracter have heen presented. 

Slight attacks of pleurisy will, in general, require nothing 
more than warm teas, and small doses of lobelia, together with 
the vapour bath or foot bath to excite perspiration, and the pa- 
tient kept warm. 

When the symptoms are more violent, the patient should be 
kept under tlie influence of lobelia given in broken doses, and 
an occasional injection in very severe cases, composed of a tea. 
spoonful of lobelia in tincture or powder, in luke warm water 
and retained some minutes. An occasional dose of composition 
or a tea of bay berry and pepper should be given to assist in main- 
taining an equilibrium ol tbe circulation, and to excite and cor- 
rect the secretions of the stomach. 

The Vapour Bath is of great advantage in pleurisy: when the 
patient's strength will not permit his sitting up, the vapour can 
be applied in bed, and in this way continued for hours, if neces- 
sary. 

An emetic must be given occasionally after a vapour bath, or 
whilst the patient is in a perspiration by other means. 

A dry heat should not be applied around a patient when there 
is much fever, as it will increase the distress, before perspiration 
is induced. 
« 

A warm poultice applied to the side will in many instances be 
attended with an immediate mitigation of pain. The poultice 
may be made of Indian mush, well boiled; or of boiled potatoes 
mashed; or slippery elm and flaxseed stewed together. A por- 
tion of ginger should be added to the poultice, and when spread 
the surface covered with powdered lobelia. The poultice should 
not be allowed to get cold, but kept warm by means of a hot 
brick, or jug of warm water placed in contact with it. 

Bilious Pleurisy^ as it is called, usually commences with the 
symptoms of ordinary bilious fever. This and every other va- 
riety of pleurisy, however, must be treated upon the same gene- 
ral principles. In bilious pleurisy the course of medicine should 
be more frequently repeated than in simple pleurisy. 

The diet, during the active stage of the disease, may consist of 
the lightest kind of food, as elm gruel, barley water, crust coffee, 
arrow root, gum arable water, or flaxseed tea, sweetened with 
honey. 

As the disease subsides, the quantity of lobelia may be less- 
ened, and the patient allowed more nourishing food, as essence 



i 



102 CATARRH — COMMON COLDS. 

of beef, boiled chicken, oysters, milk porridge, wild game, &c.? 
with stale bread and good tea or coffee. 

In some instances the treatment will require to be continued 
several days before an abatement of the disease be perceptible.. 
The expectoration of a thick yellow matter is one of the first, as 
it is also one of the surest indications of a favourable change be- 
ing about to take place. 

Some medical writers state, that an increased oppression of 
breathing and suppression of expectoration is apt to occur in 
pleurisy about the fifth or sixth day. 

. In cases of extreme prostration, from constitutional debility, 
or long continuance of the disease, a free use of w ine whey with 
five or ten grains of carbonate of ammonia added thereto, say a 
wineglassful of the whey, and this dose given every hour or two, 
as the symptoms may indicate; in connection with capsicum and 
Virginia snake root tea — and if the cough be dry, or the expec- 
toration scanty, or of an unfavourable appearance, the lobelia 
should be used in connection with the above articles. 

Tonics — Such as spice bitters, Colombo, Virginia snake root, 
&c. are indicated where the patient remains weak after the dis- 
ease has passed off. A dose of composition or bayberry tea 
should be taken once or twice a day during the convalescence^, 
until the tongue becomes clean and of a healthy appearance. 



SECTION VII. 



CATARRH—COMMON COLDS. 

Catarrh, or common Colds, prevail to a greater extent tfian dis- 
ease in any other form. At particular seasons, especially in the 
spring and winter, when south winds prevail, the majority of 
persons exposed to the weather will be more or less affected with 
catarrh. Not only do catarrhal affections prevail more during 
the general thaws of spring and in open w inters, but other forms 
of disease also prevail, to a much greater extent during those 
seasons when the atmosphere is chilly and charged with mois- 
ture, and damp from rain or from the thawing of frozen earth. 
The majority of cases of consumption originate from neglected 
colds, contracted during winter and spring. There is scarcely 
a form of disease that may not be produced by exposure to cold 
and dampness. Even contagious diseases, such as scarlet fever 



CATARRH — COMMON COIDS. 103 

^nd measles, are much more common during winter and spring 
than at other seasons of the year; and in many instances child- 
ren are taken down with a contagious disease fi^m certain con- 
ditions of the atmosphere, Avithout their having been exposed to 
any one affected with the disease. 

Catarrhal Jlffections, like other forms of disease, arise from a 
loss of heat, ajid diminution of the nervous energy. When south 
winds prevail during spring and winter, the atmosphere is high- 
ly charged with moisture, which condenses on the walls and thus 
renders houses damp and unhealthy; the clothing of those ex- 
posed to the weather becomes damp, which, together with expo- 
sure of the feet to the wet ground, will almost necessarily occa- 
sion more or less disorder of the system. When the nervous en- 
ergy and heat of the system is reduced, digestion is enfebled and 
in proportion as the digestion is lost, will the system lose its 
power of generating heat. Hence ^' other circumstances being 
equal," a cold will be protracted in proportion as the digestive 
powers are weakened. Dr. Franklin used to say that he could 
bring on a cold by over eating. When the stomach is op])ressed, 
less heat is generated in the system, and necessarily predisposes 
the person to take cold. 

Symptoms, — Most of the symptoms attending ordinary colds, 
are such as usually prevail in the first stage of almost every 
form of disease; such as lassitude, chilliness, furred tongue, loss 
of appetite, torpid bowels and a dry skin. There is usually more 
or less cough, which is dry at first, but when tlie cold is on the 
decline a free expectoration of a yellow secretion takes place. 
The secretions from the nose are thin and watery at first, but be- 
come thick and copious as the disease abates. Extreme sore- 
ness of the throat is Yery common in colds, attended with dry- 
ness of the parts, and pain on attempting to swallow. The 
breathing is greatly oppressed in some instances, and but slightly 
so in others. Generally more or less fever comes on in the after 
part of the day, and the patient is restless at night. 

Favourable Symptoms. — Cleaning of the tongue; a free ex- 
pectoration of thick yellowish, or cream-like mucous; the dis- 
charge of thick secretions from the nose; a tendency to perspi- 
ration, and a returning appetite, indicate a favourable and speedy 
termination to the cold. 

Treatment. — Ordinary colds require nothing more than an 
occasional dose of composition or capsicum tea, and a strict at- 
tention to diet, and care to avoid exposure to cold or dampness. 

Where patients are exposed to the open air, while engaged in 



104 CATARRH — COMMON COLDS. 

their usual avocations, or to sudden changes of temperature, the 
hot medicine, such as capsicum and composition powder, should 
be taken in cold water. Taking freely of hot teas will open the 
pores of the skin, and may render the patient at the time, more 
liable to take fresh cold, if exposed to dampness, or a current of 
cold air. But where the patient is in bed, or not exposed to 
the cold air, hot teas should be taken to promote perspiration, 
assisted by w^arm applications to the feet. Simple teas of penny- 
royal, dittany, or chamomile, are beneficial, and may be drank 
freely, to induce perspiration. 

When liquids oppress the stomach, the compound lobelia pills 
will answer as a general medicine in all such cases. 

Where the cough is hard and dry the patient must be kept 
slightly nauseated with lobelia, and cough mixtures employed, 
such as flaxseed or elm tea, with the addition of a portion of 
lemon juice and loaf sugar; onion syrup; bran tea; lemon juice 
with loaf sugar; or liquorice root tea. 

For sore throat wrap a stocking around the neck on going to 
bed, and keep tiie neck w^armly covered at all times. Molasses 
and butter melted together, adding a portion of cayenne pepper, 
taken at bed time, will be useful in sore throat. 

When the cough continues dry and hard, and the breathing 
oppressed, a course of medicine ought to be given, and the same 
repeated at proper intervals, until the symptoms become more 
favourable. 

Of the Consequences of Colds.— Th^VQ is scarcely a form of 
disease that is not in the majority of instances, occasioned by 
^* taking cold,^" The origin of almost every case of pleurisy, 
may be traced to a loss of heat and nervous power, either from 
exposure to cold and dampness, or from a loss of digestion by in- 
temperance in drinking, or overloading the stomach with food 
difficult of digestion; in which case the power of generating heat 
will be diminished in i\iQ same proportion as the stomach is op- 
pressed, or its powers enfeebled^ 

In fine, the first symptoms in every acute disease, are such 
as indicate a loss of heat and nervous influence, and reason 
teaches that the treatment should be directed to restore the 
natural heat of the system, the loss of which occasions the dis- 
ease. Whether a disease be brought on by exposure to cold 
and dampness, or be occasioned by an oppressed stomach, which 
lessens the power of generating heat, the indications for the treat- 
ment are the same. Exposure to cold and dampness, by abstract- 
ing heat and nervous powder from the system, enfeebles the action 
of the stomach, and thus lessens the heat-producing power: the 
appetite becomes impaired, and the patient is affected with lassi- 
tude and chilliness; and disinclination to corporeal or mental ex- 



CHOUP — HIVES. 105 

crtion. There is general torpor of the system, and extreme 
sensibility to cold. And again, if the stomach be oppressed by 
food that it cannot digest, the heat-producing power is weakened, 
and the patient will experience the same symptoms as from ex- 
posure to cold. In the first instance the heat is carried off by 
cold and dampness, and in the latter the power of producing heat 
is diminished. 

The effects of cold upon the system are exceedingly various: 
thus one wiiose digestion is strong may undergo long exposure 
to cold, but digestion being carried on vigorously, the lost heat 
and nervous power is soon supplied, and but little inconvenience 
is experienced. Whereas one of feeble digestion may become 
dangerously ill, by a very slight exposure. Thus, some women 
will remain for hours in a cold spring house, during the hottest 
w^eather, and experience no inconvenience, whilst in others it 
would be followed by dangerous illness, and probably occasion 
death. 



CHAPTER IV. 
mSBJiSE AFFECTING THE MOUTH AjYI) THROAT 

SECTION I. 



CROUP—HIVES. 



This dangerous disease is peculiar to childhood, usually oc- 
curring between the first and fifth year. 

Croup is caused by cold, or sudden changes of weather; or it 
may be occasioned by a disordered stomach or bowels. 

Symptoms.— The disease sometimes comes on suddenly, but 
generally its approach is gradual, with the usual symptoms that 
accompany a cold. — Slight oppression of breathing, with a pe- 
culiar hoarse and shrill cough; the eyes are watery and heavy, 
and the child is dull and fretful. These symptoms frequently con- 
tinue some days before the disease assumes a violent form. The 
cough becomes at length more troublesome and shrill, and agi- 

O 



i 6 cRor p — HIVES. 

tates the child very much; the face becomes svviallen and red; tlie 
breathing more dilBicult; the skin dry and hot, with a quick and 
tense pulse; and as the disease advances, the breathing becomes 
extremely difficult, accompanied with a hissing noise. Some- 
times the cough is quite dry, and in other cases there is a copious 
secretion from the wind-pipe from the commencement of thedis* 
ease. If the symptoms are not relieved, and the disease pro- 
gress in violence, the breathing becomes still more distressing, 
the child manifesting by its countenance and actions, the great- 
est degree of suffering; the head is thrown back; the eyes are 
half closed, and cast about with an imploring expression for re- 
lief; the face becomes pale, and covered with large drops of 
sweat; the lips livid; the voice becomes extinct; the extremities 
grow cold; slight stupor ensues; and finally the heat and sensi- 
bility continues to diminish until the breathing ceases. 

Spasmodic Croup, (as it is termed,) generally comes on sud= 
denly, and without fever. The cough is not of that peculiar 
sound that generally characterizes common croup; and in some 
instances there is an entire absence of cough. 

Frequently Fatah — The great danger attendant on croup, 
arises from obstructions in the throat or wind-pipe, preventing 
the free admission of air to the lungs. The obstruction may 
consist either in the formation of a false membrane in the wind- 
pipe, — filling up its cavity; swelling and inflammation in the 
epiglottis, or from spasm in the muscles of the throat. The free 
admission of air into the lungs being obstructed, the blood loses 
its vitality in proportion as the supply of air is lessened, and is 
thus rendered incapable of supporting life. Croup is extremely 
liable to terminate fatally to the patient, unless checked in its 
€arly stage by appropriate treatment. 

Treatment — The means to be relied upon for the cure of croup 
are, emetics, injections, and the vapour bath. 

Emetics. — In the early period when the symptoms are of a 
mild character, and the child in good health otherwise, an 
emetic of the tincture of lobelia may give immediate relief, 
and remove the disease. If this should not afford relief in 
a short time, say ten or fifteen minutes, the dose should be re- 
peated at frequent intervals, and injections administered, com- 
posed of composition tea, with the addition of a teaspoonful of 
lobelia powder, and place the feet in warm water. 

Vapour Batlu — Unless the patient be entirely relieved by the 
above meanS; the steam bath should be administered, and during 



CROUP — HIYES. 107 

the steaming, bathe the head and face with whiskey, or vinegar 
and water, and if the patient be faint, dash cold vinegar or water 
on the breast. It is said that a sudden dash of cold water on the 
breast in croup has been found beneficial by exciting reaction, 
when the child had become affected with stupor. 

Where the symptoms are not sa urgent as to require an im- 
mediate emetic — for instance, when the child has had a cold for 
two or three days more or less, which begins to manifest symp- 
toms of approaching croup,the vapour bath must be administered, 
previously to the emetic, in order to insure an effectual opera- 
tion. 

After the bath, a prompt emetic must be given, and frequent- 
ly repeated until the disease be expelled. The liquid of the 
third preparation of lobelia, with an equal quantity of brown lo- 
belia, forms the most efficient emetic: to be given in bayberry 
or sumac tea. In very young children, the brown or green lo-= 
belia may be prepared in the above tea, or in composition tea, 
omitting the third preparation. The lobelia cannot be given 
too freely to a child in croup, and the more effectually the sys- 
tem becomes relaxed under its influence, the greater certainty 
there will be of effecting a cure. 

Injectio7is. — These should be frequently administered in croup, 
not only with a view to relieve the bowels, but more especially 
to excite an afflux of blood to the bowels, and in this way to lessen 
the determination to the throat. I have on several occasions 
observed signal benefit by the administration ot' an injection of 
a small teaspoonful of green lobelia powder in luke warm water, 
and retained in tlie bowels ten or fifteen minutes, or even longer. 
No injury will arise if it should remain for hours. Under 
the influence of lobelia thus administered, free vomiting will 
very generally be produced, the system will become relaxed, and 
the symptoms of croup diminish, and sometimes entirely disap- 
pear. 

The treatment should be pursued as long as symptoms of 
croup continue, or until the case prove hopeless. There are 
few cases of croup, probably, but might be cured by Thomso- 
nian remedies, if early and perseveringly applied. But after 
the disease has reached a certain stage^ — for instance, the wind- 
pipe nearly closed by the formation of a false membrane, within its 
cavity; or effusion has taken place in the substance of the epiglot- 
tis, and thus ])ermanently enlarge it, the obstruction in breath- 
ing which must necessarily attend either of these conditions, will 
be almost certainly fatal. 

External Applications. — A poultice composed of brown lobelia, 
pulverized, adding a portion of slippery elm, wet with hot water. 



108 CROUP— HIVES. 

and applied to the upper part of the throat, is highly recom- 
mended hy some practitioners. The poultice must not he allowed 
to become cold. By having two poultices, and changing them 
as the one applied becom.es cooler, full benefit will be obtained 
without exposing the throat, except momentarily, to the air. It 
is important to protect the skin of the throat, after a poultice 
has been applied; and after the removal of the poultice, the skin 
may be bathed with No. 6, or stimulating ointment, and covered 
with jBlannel or cotton. 

Cases of croup are sometimes cured even after the symptoms 
have assumed a character indicative of a fatal termination. Dr. 
Chapman mentions a case of croup to which he was called, in 
w^hich the disease had continued for three days without the symp- 
toms having been relieved, and as a last resort, they placed the 
child in a vapour bath, and as soon as the patient began to sweat, 
the symptoms were relieved. The child w'as kept in the bath 
three hours, and recovered. I knew an instance of croup, where 
a child nine months old took two ounces of the third preparation 
of lobelia in the course of seven hours, and was cured, when a 
much milder course of treatment would very probably have failed. 
The free use of the third preparation of lobelia, and the continued 
application of the vapour bath, together with stimulating injec- 
tions, will be the most effectual means where the powers of 
life are far exhausted. The steam bath, by warming the blood, 
and expanding the tissues, gives the air greater access to the 
lungs — the vitality of the blood is increased in proportion as the 
supply of air is greater, and the warmtli imparted to the skin at- 
tracts the blood to the surface, and tends to equalize its circula- 
tion. I have never applied the vapour bath in a case of croup, 
without relief to the symptoms, though in far gone cases the ben- 
efit will not be of long continuance. A child, held on the lap, 
will bear a moderate steaming for several hours at a time, pro- 
vided a proper attention be paid to bathing the head and surface 
of the body, and giving stimulants. The vapour should be of a 
temperature sufficient to keep the skin warm, and the patient in 
a moderate perspiration. In violent cases the lobelia may be 
given during the application of the bath. 

Children are subject to asthma or phthisic, which, in many of 
its symptoms, resembles croup. But any one acquainted with the 
croup cough, will be able to distinguish it from asthma. With 
regard to treatment, however, that which would be most effectual 
in croup, would be equally appropriate in asthma. 



SECTION It, 



QUINSY. 

This form of disease is characterized by inflammation and 
swelling of the tonsil glands, which are situated on each side of 
the throat and behind the root of the tongue. 

Sometimes the inflammation is confined to one side, in other 
instances both tonsils are affected. 

Symptoms. — At first there are symptoms of constitutional dis- 
order, as chilliness, loss of appetite and furred tongue, followed 
by more or less fever. The throat becomes swollen and swal- 
lowing is painful. As the inflammation and swelling increase, 
the efforts to swallow become more difficult and painful, and in 
some instances the patient is entirely unable to swallow. The 
voice becomes indistinct or whispering, and in some cases, the 
breathing is much embarrassed; the pulse is generally full and 
frequent, and the face red and tumid. There is usually a tough 
ropy mucous secreted on the inflamed surface, which is expelled 
with considerable difficulty. The swelling of the tonsils is al- 
ways observable externally, and the parts are very tender and 
painful to pressure. 

Inflammation of the tonsils is extremely liable to terminate 
in suppuration. In many instances an abscess will be formed, 
and discharge in a few days from the commencement of the in- 
flammation. There is chilliness at the time the ulcer is forming. 

Causes. — Persons predisposed to quinsy are liable to an attack 
from a sudden check of perspiration, more especially after severe 
exercise or fatigue. Exposure to cold damp air, and standing 
on damp ground, are the principal exciting causes of this dis- 
ease. 

Quinsy is rarely attended with much danger when properly 
treated from the commencement. 

Treatment — To promote perspiration, and to cleanse the sto- 
mach and bowels, are the most important indications for the cure 
of quinsy. A full course of medicine will be proper in the com- 
mencement, as the surest means of moderating the violence and 
lessening the danger of the disease, and in some instances it will 
put a sudden stop to a further increase of the inflammation and 
swelling. 



110 qUINSY. 

In violent cases the patient should be kept slightly nauseated by 
broken doses of lobelia in composition or such other warm teas, 
as are good to promote perspiration. When there is great dif- 
ficulty in swallowing, the lobelia may be administered by injec- 
tions, in small portions of luke-marm water, and retained. Vo- 
miting may be very readily eJGfected in this way, and prove of 
benefit in any stage of the disease. 

A strong tea of hayberry, or sumac with a portion of cayenne 
pepper given occasionally, and more especially when the coating 
on the tongue begins to soften, is peculiarly serviceable to cleanse 
the stomach. 

The feet should be kept warm, and occasionally placed in 
warm water. 

Gargling the throat frequently with very cold water, or vine- 
gar and water, appears to be particularly serviceable in this af- 
fection, at the same time taking freely of the hot medicine to sus- 
tain the circulation and promote perspiration. Gargles of pep- 
per sauce, or of hayberry and pepper, may also be employed 
with a view to excite the secretions and clear the throat of mu- 
cous. The tincture of lobelia may be usefully employed as a 
gargle. 

Poultices. — Slippery elm, ginger and green lobelia, forms a 
good poultice, to be applied warm to the throat, and to keep the 
poultice from getting cold, five or six thicknesses of flannel 
should be applied over it; or in place of a poultice, spread a 
plaster of stimulating liniment, or salve, on a piece of silk, oil- 
cloth, or bladder, and apply to the throat; this last application 
is preferable to a poultice at night, on account of the liability of 
the poultice becoming dry and cold. 

Inhaling the vapour from vinegar may give relief. 

When an abscess is formed in the tonsil, and the patient great- 
ly distressed from the swelling, it should be opened with a lancet 
in order to allow the matter to escape; an operation attended 
with no danger, and one which gives immediate relief. After 
the abscess has discharged, a gargle of hayberry or sumac tea 
should be used, adding a portion of the No. 6, or tincture of 
myrrh. 

Preventives, — Those predisposed to quinsy, should make it a 
practice to gargle the throat every morning with cold water, and 
occasionally sponge the body with cold water, immediately on 
rising in the morning; and keep the feet dry and warm. 



SECTIOH IV. 



MUMPS. 



This is a disease of the parotid glands, wliich are situate be- 
low the ears, and behind the angle of the jaws. It is contagious 
and often prevails epidemically. 

Sometimes the gland on one side only is affected, wiiich does 
not prevent the disease from occurring subsequently on the other 
side; but where both glands are affected, tliere is rarely ever a 
second attack. 

Children and young persons are the most liable to this dis- 
ease. 

Mumps is not a dangerous affection, though from exposure to 
cold, it is liable to be translated to other glands" in the male, to 
the testes; and in the female to the mammse, and the former 
particularly, requires judicious and thorough treatment. 

'S^2/7}i;}/o7]is.— There is swelling below the ear, extending part- 
ly over the cheek and neck, and stiffness of the jaws. The swell= 
ing increases and the parts become hard and extremely tender, 
and in some cases the patient is scarcely able to move the 
jaws. The swelling usually begins to lessen by the fourth or 
fifth day. There is more or less fever from the commencement, 
attended with restlessness, and sometimes slight delirium. 

Treatment — -Mild cases seldom require other treatment than 
keeping the parts warm, and to use some mild stimulant, with a 
view to promote moderate perspiration, as composition, ginger, 
or pennyroyal tea. 

When the symptoms are more severe, the bowels should be re- 
lieved by injections, and tlie stomach cleansed by an emetic. If 
the symptoms continue to be distressing, broken doses of lobelia 
should be given with warm tea. 

The local applications to the swelling, should consist of vola- 
tile liniments; sweet oil and spirits of hartshorn; or camphor, 
opodildock, 6cc. and the parts kept warm with flannel or cotton. 
Especial care should be taken to avoid taking cold. 

When the disease is translated to the testes, a full course of 
medicine should be administered, and the patient kept in a per- 
spiration by being in bed, and drinking of warm teas, and bro- 



112 COMMON SORE THROAT. 

ken doses of lobelia. In severe cases the patient should lye on 
his back and have the testes supported by a soft cushen, and fre- 
quently bathed with volatile liniments, or apply a soft emollient 
poultice. The poultice should be wet occasionally with warm 
water to prevent it from hardening. Stimulating applications 
should be made to the parotid glands, as bathing with the third 
preparation of lobelia, or using warm poultices containing mus- 
tard 01' pepper, and kept warm. y 



SECTION IV. 



COMMON SORE THROAT. 

Soreness of the throat arising from the same causes as quin- 
sy, is distinguished from the latter by the absence of much swell- 
ing in the tonsil glands, and no tendency to terminate in ab- 

scesSe 

Sore Throat is a common attendant on colds, and is usually 
preceded by chilliness and flushes of heat, checked perspiration, 
and impaired digestion. The throat is dry at first, and there is 
pain on attempting to swallow; cough, and sometimes an inclina- 
tion to vomit. There is a discharge of a thick yellowish mucous 
takes place sooner or later, and the soreness and inflammation 
subsides. ' 

The treatment should consist of hot medicines to warm the 
stomach and bowels, and promote perspiration, assisted, if ne- 
cessary, by the warm foot bath or vapour bath, and the feet kept 
warm. 

Jin Emetic will be of benefit in severe cases, and small doses 
of lobelia given to produce slight nausea. This is more particu- 
larly indicated when the skin is dry or where there is fever. 

The best Gargle for sore throat is capsicum tea; or pepper 
sauce. When the inflammation subsides, and a thick yellowish 
mucous is secreted, astringent gargles should be used, such as 
sumac or bay berry tea. 

There is a variety of other remedies useful for colds and sore 
throat, as flaxseed, or slippery elm tea, with the addition of a 
portion of lemon juice, and sweetened with rock candy; honey 
and vinegar, molasses and fresh butter stewed together with the 



APTHOUS SORE THROAT. 113 

addition of a portion of red or black pepper, is a good remedy 
for ordinary sore throat. 

Filling a stocking with hops moistened with hot vinegar, and 
applying it to the throat at night, will generally put a stop to the 
further increase of the inflammation. This is a good application 
in the early stage of quinsy. 

The Constitutional Treatment for sore throat, is precisely such 
as should be employed in bronchitis, catarrh, quinsy, or any 
other disorder of the kind. Herein is the excellency of the 
Thomsonian system: embracing a few general principles, which 
are applicable to all cases. The human constitution is governed 
by general laws which are unvarying and unchanging. And 
although disease may appear in a variety of forms, yet it is al- 
ways the same in principle, requiring but few general reme- 
dies, applied to suit the circumstances of the case. 



SECTION T. 



APTHOUS SORE MOUTH. 



In this disease there is a secretion which forms in patches 
over the tongue and mouth resembling whey curd. In some 
cases the disease spreads and covers the tongue, and occasionally 
extends to the stomach and bowels, appearing at the anus, — 
these parts becoming excoriated. 

Local Treatment. — In the first place rub off these white patches 
with a dry rag; then wet a finger, and cover it with fine bay- 
berry powder, and rub over the tongue and sides of the mouth. 
Then lay on the tongue some finely powdered chalk, mixed with 
an equal quantity of loaf sugar. These applications will gen- 
erally cure in a few times repeating. Rubbing the dry powder 
over the surface stimulates the raucous glands, and changes the 
secretions to a healthy condition. 

Constitutional Treatment^ in mild cases, is seldom necessary, 
more than to allow the child to swallow the chalk and sugar 
laid on the tongue. 

In more obstinate cases, give the child two or three times a 
day, a tablespoonful or more of the strong decoction of bay berry 
or sumac, with the addition of half a teaspoonful of powdered 

P 



114 ELONGATED tJVUlAe 

chalk, and sweetened. And if there be symptoms of the disease 
having spread throughout the stomach and bowels, besides the 
above mixture, give three or four times a day, half a teaspoon- 
ful of composition powder, in a tablespoonful of bayberry tea; 
and use injections to regulate the bowels. If this is not suffi- 
cient, apply the vapour bath to w arm the blood, and give an 
emetic to cleanse the stomach. 



SECTION VI* 



ELONGATED UVULA"="FALLING OF THE PALATE. 

The uvula, a small fleshy body, hanging from the middle of 
the arch of the palate, over the root of the tongue, is liable to 
become elongated, from exposure to cold and damp weather, or 
from an acid or otherwise disordered stomach. Sometimes 
there is but a slight lengthening of the uvula, and in other in=" 
stances it becomes greatly elongated, having sometimes the ap- 
pearance of a bladder of water, and is very troublesome to the 
patient from the unpleasant sensation occasioned by it in the 
throat. 

From a frequent occurrence of this affection, the uvula is liable 
to become permanently elongated, and to excite frequent cough° 
ing, which in some instances does injury to the lungs. Cough 
of long standing is sometimes cured by the removal of a part of 
the uvula, where it had become elongated. 

Treatment — Recent cases of this affection may, in general be 
readily cured by a few doses of composition, or of bayberry and 
pepper, and using a gargle of black pepper and whiskey, or a 
strong decoction of some vegetable astringent, as bayberry, su= 
mac, witch hazle, or marsh rosemary, adding cayenne pepper. 

When the uvula becomes permanently lengthened, and excites 
troublesome coughing, a portion of it should be cut off, provided 
the above gargles have no effect in exciting it to contraction. 
The clear No, 6, or the third preparation of lobelia, may be 
also used as a gargle where the parts have been long affected. 



CHAPTER V. 

DISEASE AFFECTIJ^G THE STOMACH AJ^D BOWELS. 

»ECTI01»r I. 



COLIC. 

Colic is usually divided by medical \\Titers into at least 
three varieties, namely, Accidental or Flatulent Colic^ Bilious 
Colic, and Colica Pictonum, or Fainter^s Colic* 

1. Flatulent Colic.-— This species of colic is produced by a 
collection of wind or flatus in the stomach or bowels, from indi- 
gestion. Persons of weak digestion and acid stomach are liable 
to colic from inaccuracies in diet, or from drinking freely of 
cold liquids, such as lemonade, ice water, or cold milk. Colic 
generally comes on an hour or two after eating, yet sometimes 
immediately after. Before the pain seizes the patient, he gen- 
erally feels a sensation of fullness and distress at the pit of the 
stomach. In some instances the food passes into the bowels im- 
perfectly digested, and the colic does not come on until several 
hours after eating, and the pain is chiefly about the umbilicus 
or navel. When tlie pain is severe the patient bends his body 
forward, and tvvists about with his hands pressing hard upon 
the abdomen. The pain is generally lessened whenever there is 
wind forced upward or downward. Sickness at the stomach 
almost always accompanies colic, and if free vomiting take place, 
the distress is greatly mitigated, and sometimes entirely re- 
lieved. 

Distinguishing Signs. — x4 disposition to press the hand upon the 
belly; the bending and twisting of the body; the frequent belch- 
ing of wind, and absence of fever, serve to distinguish colic from 
inflammation of the stomach. In painter-s colic, the abdomen, 
instead of being distended, is contracted, hard, and rigid, and 
the pain comes on and increases by slow degrees. 

Treatment of Flatulent Colic.'— In colic there is a want of 
power in the stomach or bowels to contract and expel the wind. 



116 COLIC* 

The chief indication, therefore, for the treatment, is to adminis- 
ter such stimulants, hy the stomach or by injections, as will ex- 
cite contraction, and expel the Jlatus. 

Stirmilants. — There are a variety of stimulants, either of which 
may answer in mild cases; such as capsicum or composition tea, 
Thomson's No. 6, oil of juniper, spirits of turpentine, or essence 
of peppermint. The teas must be drank as hot as the patient 
can bear them. 

Emetics* — A prompt emetic of lobelia is the most effectual 
means for curing colic, when the pain is in the stomach. The 
liquid of the third preparation of lobelia to be given in hot com- 
position or bay berry tea; or the lobelia powder and JNo. 6, used 
in place of the third preparation. 

The Vapour Bath^ not only has a tendency to relieve colic, but 
it assists the operation of the emetic; the bath, however, will 
seldom be necessary except in very severe cases, and in case the 
system be very cold or torpid. 

Injections. — -When the pain is seated in the bowels, injections 
may be given, prepared in the usual way. A prompt emetic, 
however, will generally overcome pain in the bowels. When 
the stimulating injections are expelled suddenly, without afford- 
ing relief, the lobelia powder should be administered in warm 
water, and care should be observed to retain them as. long as 
possible. 

External Applications.— Flsinnels wrung out of hot water, or 
wet with hot whiskey, or No. 6; or hot bricks wrapt in damp 
cloths, should be kept to the stomach and bowels. Heat applied 
to the feet is also beneficial. 

Jlnti-adds. — In most cases of colic there is acid in the sto- 
mach, interfering with the free operation of emetics, which 
I'equires to be neutralized by alkalies, such as salaeratus, bi-car- 
bonate of soda, or a tea of hickory ashes. Soot tea answers the 
same purpose, and will of itself, when drank freely, cure mild 
cases of colic. 

"When lobelia is not at hand, or cannot be readily obtained, 
a teaspoonful of mustard in warm water, a tumbler of w^arm soot 
water, or warm chamomile or bonesett tea, may be given to pro- 
duce vomiting. 

Infants are peculiarly liable to colic pains, which may be re= 
lieved generally by the most simple remedies; as warm tea of 



CHOLERA MORBUS. IIT 

catnip, ginger, calamus, or mint. Adding a few drops of the 
essence of peppermint, or tincture of lobelia, will render the teas 
more effectual. 

Soot tea is very good for colic in infants: emetics, however, 
are sometimes necessary. 



SECTION II. 



CHOLERA MORBUS. 



This form of disease is occasioned by indigestion and want of 
vital power in the system to generate heat and nervous influence. 
It is common in hot weather, but more particularly in autumn. 

Stjmptoms. — Cholera morbus usually comes on suddenly, com° 
mencing with distress and pain at the pit of the stomach and in 
the bowels, followed by severe vomiting and purging. When 
the symptoms are violent, the strength is rapidly exhausted, and 
great distress is felt at the pit of the stomach. The thirst is 
excessive — and in many instances, the patient is harassed by 
cramps in the muscles of the abdomen and lower extremities, 
and the pulse is usually irregular and feeble. The severe and 
continued retching, and strong efforts to vomit, generally occa- 
sion more or less bile to be tlirown up, which is observable also 
in the evacuations from the bowels. 

The aggravated form of this disease which prevailed a few 
years since, received the name of Asiatic cholera. 

Cholera is generally rapid in its course and frequently termi- 
nates /fl^a^/i/, under unfavourable circumstances; as when it oc- 
curs in vitiated and broken down constitutions, or when the pa- 
tient is subjected to an improper course of treatment, such as 
large doses of narcotics, or calomel; or when the vital powers 
are prostrated by the loss of blood. 

Causes — There are certain atm.ospheric influences that evi- 
dently predispose the system to cholera morbus. The general 
exciting cause of the disease is, a sudden check to perspiration; 
unwholesome food, or that which is hard of digestion; intemper- 
ance, and drinking copiously of cold water on an empty stomach. 
In some seasons, almost every person that is sick will have more 
or less of bowel complaint. Intermitting fever sometimes com- 



118 CHOLERA MORBUS. 

mences with a violent attack of cholera morhus. During the 
season that the cliolera prevailed throughout this country, almost 
every person had, more or less, a looseness and disorder of the 
howels, showing very plainly that there must have been a cause 
in the air which tended to weaken the vital principle and enfee- 
ble the powers of digestion. 

Treatment of Cholera Morhus. — The most important indica- 
tion in the treatment of cholera morbus, is a thorough emetic and 
a free use of injections. The vapour bath should be adminis- 
tered, or hot bricks, or bottles of hot water, wrapped in damp 
cloths placed around the patient. As long as the symptoms of 
retching and purging continue, together with pain and cramp, 
the third preparation of lobelia Timst be giveninfull and frequent 
doses. A milder stimulant, for instance, as composition, will in 
many instances be thrown off the moment it is swallowed, with- 
out producing a sufficiently beneficial result. I have witnessed 
cases in which every thing swallowed had been rejected instant- 
ly, with the exception of the third preparation of lobelia which 
always remained several minutes before it was thrown off, and 
would bring morbid matter from the stomach, which could not 
have been thrown off without it. I know of no form of medi- 
cine of equal efficacy, in all bad cases, as the third preparation 
of lobelia in bayberry tea. Patients in many instances have con- 
tinued retching and vomiting for hours in succession, raising 
scarcely any thing, yet by taking a vapour bath to warm the 
blood and restore the nervous power, or excitability of the sys- 
tem, followed by a prompt emetic, large masses of undigested 
food have been thrown off, and the stomach become settled in a 
short time. Therefore it will not do to be satisfied without giving 
an efficient emetic, as long as the stomach continues its efforts to 
relieve itself, or the system sinks into a collapsed state. Even 
though the system should not contain any thing that requires to 
be removed, and the retching continues from an unsettled, or as it 
is termed, an irritable condition of the stomach, the em.etic would 
be as likely to quiet the stomach as any medicine that could be 
given. 

Dr. George M'Clellan stated in one of his lectures, that in the 
post mortem examinations that he made where patients died of 
cholera, he invariably found the stomach more or less filled with 
masses of undigested food, and in many instances observed sub- 
stances, that must have been swallowed many days previous to 
their death. The doctor adopted the practice of giving prompt 
emetics in every case that came under his care, and by this 
course of treatment he succeeded in raising every patient sub= 
jected to this mode of treatment. 

Flannels wrung out of hot brandy or No. 6, should be applied 
over the abdomen. 



CHOLERA INFANTUM. 119 

After the disease be checked, which it almost always is, under 
thorough Thomsouian treatment, the patient must remain quiet, 
and warm in bed, and take occasionally some spice bitters and 
pepper tea; or the No. 5 syrup, or cholera syrup may be taken 
occasionally. 

I have very little confidence in cholera syrup, or any thing 
else short of an emetic, except in light cases. 

The digestion being left weak, care will be necessary to regu- 
late the diet, and to avoid all kinds of fruit, pastry, and every 
thing difficult of digestion. Milk porridge, barley water, cus- 
tards, &c. will be proper; and, if the patient desire it, he may 
take moderately of boiled or broiled ham, and also the thin part 
of a salt mackerel boiled^ but neither broiled nor fried. 

To allay thirst the mouth and throat may be gargled frequently 
with cold water, but cold liquids must not be swallowed, except 
in very small quantities. Capsicum tea by exciting the secre- 
tions, will generally allay thirst. 

A mustard plaster over the pit of the stomach will have a ten- 
dency to allay the vomiting and relieve the pain; taking care to 
remove the mustard, however, before it produces a blister. 



SECTION III. 



CHOLERA INFANTUM— CHOLERA OF INFANTS. 

Infants are especially liable to bowel complaints arising 
from indigestion, particularly when they are teething. When 
there is both vomiting arjd purging, it is calhnl cholera infantum. 
It seldom comes on suddenly violent, as it happens in the cho- 
lera of adults; generally commencing with diarrhcsa, which 
continues several days, before vomiting take place: occasionally 
however, the vomiting and purging comes on simultaneously. 

Infantile cholera, like that of adults, arises from a loss of the 
power of digestion; the food being imperfectly digested, becomes 
sour and acrid, and offends the stomach and bowels, similar to 
an irritating cathartic; for instance, mandrake, or jalap. The 
constitution endeavouring to cast off the undigested matter by 
vomiting and diarrhoea. 

Cholera of infants is usually much more protracted in dura- 
tion than that of adults; generally continuing for several days, 
and not unfrequently it becomes chronic. In many instances, 
however, the vital powers sink rapidly^ and the disease, if not 



120 CHOLERA INFANTUM. 

subdued, will become suddenly fatal. Where the disease is un- 
checked, the strength soon becomes greatly exhausted; the flesh 
wastes rapidly; the countenance becomes shrunken and pale; 
the extremities cold; the belly swollen and hot; the skin dry and 
husky, or cool and flaccid; the discharges from the bowels fre- 
quent, watery, and acrid; the little patient doses with his eyes 
half closed, and rolls his head when awake. The eyes become 
sunken and glassy; the lips blue; the breath cool; and finally 
the patient sinks into a state of insensibility, and in many in- 
stances dies with symptoms of dropsy on the brain. Patients 
have recovered from this disease, however, even after the occur- 
rence of the above symptoms. A feverish state of the system is 
always more favourable than an opposite condition. In many 
instances the evacuations from the bowels consist of a deep green 
fluid— the green colour probably is owing to the acid in the 
bowels, acting upon the colouring matter of the bile. 

Thomsonian treatment will generally succeed in curing cho- 
lera infantum, if timely and properly administered. 

Treatment of Cholera Infantum,-— The same general course of 
treatment is required in this form of disease, as in that for 
adults — relying chiefly upon the vapour bath, emetics, and in- 
jections, in the early stage, together with the use of stimulants 
to support the vital powers, to determine the blood to the surface, 
and to promote healthy secretions; astringents to '^remove the 
canker;" anti-acids and absorbents to neutralize acid; and 
finally tonics to restore digestion. 

The Vapour Bath. — Whoever has witnessed the effects of 
steaming in cholera infantum, must become convinced of its util- 
ity. I have, in many instances, seen little patients made com- 
fortable, at least for a time, by the bath, when they before were 
suffering the most severe spasms of pain. It is a universal 
opinion among practitioners of the old school, that the liver is in 
a state of torpor in this disease, and by failing to secrete bile oc- 
casions the stools to be of a light colour. 

From the close sympathy existing between the skin and the 
liver, the vapour bath, by its prompt action upon the skin, tends 
to restore action in the liver. Besides this, the vapour bath, when 
well applied, warms the blood, and also thins it, by quickening 
its circulation through the lungs. Steaming will also increase 
the natural sensibility of the system, and cause the emetic and 
other remedies to operate more promptly and effectually. The 
best mode of steaming infants is to do it on the mother's lap, or 
if they can sit on a table-chair this will be better. The steam- 
ing may be continued from fifteen minutes to half an hour, and 
repeated as often as the case may require, washing over the sur- 



CHOLERA INFANTUM. I2l 

face occasionally while in the bath, with spirits, vinegar, or 
simply with water. The shower hath, or dipping the child in- 
stantly from the steam into a tub of cold w ater, may be prac- 
ticed with perfect safety, except in very low cases, when there 
is not heat or nervous energy sufficient to excite reaction. Ex- 
citing reaction in this way, it is in many instances of especial 
benefit, more particularly in chronic cases. After this, the pa- 
tient should be clothed warmly, and have a flannel bandage over 
the abdomen, which may be wet occasionally with No. 6, or the 
third preparation of lobelia. 

There is no form of disease in which I have found the vapour 
bath more beneficial than in bow^l complaint. To keep the head 
constantly wet with vinegar and water, when steaming, is both 
grateful and beneficial to the patient 

Emetics may be prepared in various ways. I have generally 
found the following form to answer as well as any other: 

An even teaspoonful of green lobelia, 
Ditto of No. 6, 

In a small teacup, half full of very strong bayberry or 
No. 3 tea. The lobelia to be added to the tea when 
moderately hot. To be strained and sweetened; and 
to an infant give a tablespoonful every ten or fifteen 
minutes, until free and full vomiting is produced. 

In severe cases I have used the third preparation of lobelia, to- 
gether with a portion of the green lobelia, adding the bayberry 
tea. Green lobelia in composition tea does very well in many 
cases. 

In cases where I have deemed it necessary to continue the use 
of a diffusive stimulant, and occasionally to relieve the stomach 
by vomiting, I have given the liquid of the third preparation of 
lobelia in a small quantity of boiled milk. The best time for 
giving an emetic is immediately after steaming; still it may be 
given at any time without the previous use of the bath. 

In some cases it may be necessary to repeat an emetic every 
two or three hours; in other cases once or twice a day; and in 
others still less frequently: the nature of the case, however, will 
point out when an emetic is necessary. I have never witnessed 
any injury to arise from a too frequent repetition of prompt and 
efficient emetics in cholera infantum^ but on the contrary, patients 
are apt to be permitted to suffer, and even to sink, from oppres- 
sion of the stomach, which might liave been relieved by the early 
administration of emetics, before the powers of the constitution 
had sunk under the effects of the disease; and the heat and nerv- 
ous energy become too far exhausted for medicine to have a pro- 

Q 



J2£ GHOLERA IlVrANfUM. 

per effect. The operation of an emetic has a beneficial influenc© 
upon the liver in arousing it from a state of torpor. 

Injections. — In the early stage of bowel complaint, an injec- 
tion repeated three or four times will, in some instances, be suffi- 
cient to check the further progress of the disease. They should 
be prepared in the usual form, of composition tea and green 
lobelia, or tincture of lobelia; or of a strong decoction of some 
suitable astringent, such as bajberry, sumac, raspberry leaves, 
or dewberry root, adding a portion of No. 6 and green lobelia, 
or a small teaspoonful of the third preparation of lobelia. When 
the evacuations are green, denoting the presence of acid, or if 
they be of a frothy acrid character, a portion of salseratus, or 
a teaspoonful of the bi-carbonate of soda should be added to the 
injection. When the parts become sore and irritated from re- 
peated evacuations, or the frequent introduction of the syringe 
pipe, a gum elastic tube, made for the purpose, placed on the 
pipe of the syringe, will cause much less irritation than the me- 
tallic pipe, and by introducing the gum elastic tube four or five 
inches, the injection will have a more decidedly beneficial effect. 
In those cases where injections, given with an ordinary syringe, 
are immediately rejected the gum elastic tube, or a large catheter 
must be used for the purpose of throwing the injection so far into 
the bowels as to prevent its immediate expulsion, without having 
the desired effect. 

Composition Powder,- — As much of the composition powder as 
will lay on a ten cent piece, rubbed up with an equal quantity of 
su-gar, and then stirred into a tablespoonful of strong bayberry, 
or sumac tea, and given, repeating it every two or three hours^ 
will in general prove far more beneficial than the composition 
tea alone. In slight cases, this dose repeated two or more times 
a day, will be sufficient to check the disease, at its commencement. 
The composition, prepared in this way, may be given in all 
cases, and when rejieated two or three times a day, or as the case 
may require, it frequently has proved more effectual in my hands 
than any preparation of cholera syrup that I have ever used. 

Capsicum, though unpleasant to administer to children, is ne^ 
vertheless one of the most valuable medicines in all cases of dis* 
ordered bowels. There are few cases, probably, of cholera in- 
fantum, that may not be cured by a timely and free use of cay- 
enne pepper. An additional quantity of capsicum added 
to the composition or spice bitters, will render their use more 
effectual. A very good way to administer pepper to children, is 
to add it to a small quantity of boiled milk. It is generally more 
effectual, however, given in the form of simple tea sweetened. 



CHOLERA INFANTUM". 12S 

Wlien tlie tongue is dry and the patient thirsty, the pepper tea 
should he used instead of the composition and bayherry. I fre- 
quently combine pepper with ginger, making a strong tea of them, 
and give a teaspoonful with the addition of ten or fifteen drops 
of the tincture of lobelia every half hour. 

External Applications — These may consist of stimulating lin- 
iment, No. 6, or the third preparation of lobelia applied to the ab- 
domen; or warm poultices over the region of the bowels, composed 
of composition powder and green lobelia, moistened with warm 
w^ater, enclosed in gauze or book-muslin, and applied to the 
parts. The poultices must be kept warm, for if they become cold 
they will be likely to do harm. It is a good plan to have two 
poultices and change them when they become too cold or dry. 
Mustard plasters over the stomach are useful in some cases, 
more particularly where the stomach remains irritable and the 
patient continues retching after the operation of an emetic. The 
mustard must be removed before it draws a blister. 

Anti-acids, — A w eak tea made by pouring boiling water upon 
common soot and sweetened, will relieve colic pains, by caus- 
ing the removal of the flatus from the stomach. The soot tea, 
or salseratus, or bi-carbonate of soda, is sometimes necessary to 
be given to neutralize the acid in the stomach, before an emetic 
will operate effectually. 

JDiet, — During the active stage, or until the disease be checked, 
a most careful attention will be necessary in the selection of food. 
It is better to give the patient no food, at least for a reasonable 
length of time, than to introduce such into the stomach as it can- 
not digest. Bermuda arrow-root, gum arable, crust coff*ee, cof- 
fee made of scorched rice pulverized; milk porridge, Irish moss, 
boiled milk, oat meal gruel, or barley water, forms the most 
suitable article of diet. It will be proper in severe cases to use 
some one of the above articles for infants that have not been 
weaned, for the mother's milk will in some cases be thrown up 
in solid masses soon after it is swallowed, or passed off* by the 
bowels in an indigested state. The excessive thirst attending 
the disease will induce an infant to take the breast almost con- 
stantly, and take large quantities of milk into the stomach, wiiich 
sometimes forms into masses of cheese-like substance, and will 
greatly increase the suff*ering, and even endanger the life of the 
patient. Drink, as well as food, should be given in very small 
quantities. A teaspoonful of gum arable w^ater, or of barley 
water, is as much as should be given at once, in cases where the 
stomach is very weak; this quantity, however, may be given 
very frequently. 



124 CHOLERA INFANTUM. 

As long as food passes through the bowels undigested, sucli 
articles of diet must be given as are least disposed to sour or 
ferment, such as calves' foot jelly, gum arable water, and crust 
coffee, and even these in very small quantities. The thirst may 
arise from a curative action in the stomach, and if large quantities 
of liquids be taken, the stomach may thereby become oppressed, 
and unable to recover its diminished vitality. 

As the stomach and bowels become more settled, and the stools 
present a more favourable appearance, such as small portions of 
natural fseces, with thick secretions, in appearance, J like small 
flakes of a skin-like substance, together with bilious matter, 
showing that the functions of the liver are being restored, then 
stronger food may be given, as chicken tea, essence of beef, with 
crackers or stale bread, and milk porridge. Salt should be add- 
ed to the food, as this is a most important article in most cases 
where patients are recovering from sickness. Patients, in re- 
covering from cholera very often have a craving for salt food, as 
old bacon, and salt fish, which will be found not only to gratify 
the patient, but will tone the stomach, and cause an immediate 
improvement in the symptoms. The thin part of salt mackerel 
boiled, or a small piece of salt ham boiled, or broiled, may be 
given, and the use of it continued, provided it be found not to 
disagree with the stomach or bowels. *' I have seen many chil- 
dren recover," says Dr. Rush, '' from being gratified in an in- 
clination to eat salted fish, and the different kinds of salt meat. 
In some instances they evince an appetite for butter, and the 
richest kinds of gravies from roasted meat, and eat them to the 
obvious relief of all their symptoms." Patients are subject, 
however, to morbid cravings for food, which may be found to 
disagree witli the digestive organs, and it will therefore be ne- 
cessary to exercise proper discretion in granting much indul- 
gence to extraordinary cravings for particular articles of food 
or drink. A child may crave sweet cakes, as ginger bread and 
pound cake, and yet they may be decidedly injurious; or there 
may be a craving for cold water, which if given too freely, might 
occasion fatal symptoms. To restore digestion, the No. 5 syrup 
may be used, or a tea made by steeping in boiling water, equal 
portions of powdered black or sweet birch bark, aspen, poplar, 
and pounded cherry stones. The tea to be sweetened with loaf 
sugar, and given in tablespoonful doses three or four times a 
day. This preparation will in many instances cure ordinary 
diarrhoea, both in children and in adults, and is not unpleasant 
to take. It becomes more effectual by the addition of a portion 
of No. 0. A strong tea of the poplar bark alone, will answer as 
a tonic. 

When the disease becomes chronic, and medicines have 
failed of effecting a cure, or if the child be subject to frequent 



CHOLERA IXrANTLM. 125 

relapses, there is probably no means so likely of success, as a 
change of air, or the cold shower bath. It frequently happens 
that taking a child with this disease from the city to the country 
air, will in a few days restore the appetite, and the patient will 
begin to gain rapidly in flesh and strength. 

The Cold Salt Water Bath, — In most cases of chronic disease 
of the bowels, where the patient continues feeble and emaciated, 
much benefit may be derived by dipping the patient every morn- 
ing in a tub of cold salt water. If the patient be excessively 
wxak, it will be prudent to temper the water at first by adding 
a portion of hot water. After being dipped, the child should be 
wrapped in a blanket, and placed in a warm bed, in order to 
favour reaction; and if the child becomes warm in fifteen minutes 
or half an hour, it will most certainly be beneficial. I have, in 
repeated instances, known cures to be effected by the daily use 
of the cold bath, where medicine had apparently lost all effect. 

Lancing the Gums is often of benefit in the early stage of cho- 
lera infantum; more particularly when the diarrhoea first com- 
mences; but where the disease has prostrated the strength of the 
little sufferer, and more particularly if the gums be spongy, 
cutting them will not only prove useless, but hazardous,, on ac- 
count of the excessive bleeding which is liable to take place when 
the gums are in a spongy state. 

Preventives. — Cleanliness ; cold baths in the morning; avoid- 
ing all unripe fruit, sweet cakes, pastry. Sec; lancing the gums 
when teething; residence in the country, and a flannel bandage 
over the abdomen, are good preventives. 



SECTION IT. 



BILIOUS COLIC. 



When colic is accompanied with bilious vomiting, or the skin 
and whites of the eyes become sallow, it is termed bilious colic. 
The supposition that an overflow of bile occasions the disease, 
has given rise to the name of bilious colic, when in reality the 
liver is in most instances in a torpid condition, and secretes less 
bile than when in a state of health. The digestion being impaired 
or suspended, the bowels cold and inactive, the bile is not used^ 
and being retained in the duodenum, it is drawn into the sto- 
mach by the act of vomiting, and thrown up. A vitiated 
state of the bile is doubtless a frequent cause of the sickness and 
vomiting, but this unhealthy condition of the bile is an effect, and 
not the cause of the disease. 

Bilious colic is more liable to occur in autumn, and especially 
in localities where ague and bilious fever prevail. 

In most instances the general health is considerably deranged 
before tlie attack of colic is manifest. The appetite is impaired; 
the tongue coated with fur, and the bowels costive, or otherwise 
disordered. The skin is dry, and frequently there is pain and 
soreness in the back; an uneasy sensation at the stomach, bad 
taste in the mouth, headach, nausea, and sometimes vomiting. 
These symptoms are followed by cutting pains in the stomach 
and bowels; sickness at the stomach, and vomiting : frequently 
bile is thrown up. The pain increases, and in many instances, 
assumes a very violent character. There is great prostra- 
tion of strength, and usually some attending fever. The bowels 
in almost every instance, are obstinately constipated, having 
lost their power of action. As the disease continues, the abdo- 
men becomes sore and tender to pressure, and in most instances 
the complexion has a yellow tinge. The duration of the disease 
varies greatly in different cases, and as it occurs under different 
circumstances, sometimes it is overcome in a few minutes, by 
proper treatment in the commencement, and in other cases it 
will continue with more or less severity, at intervals, several 
days in succession. 

Treatment of Bilimis Colic. — A full course of medicine timely 
administered, will overcome the pain, and check the further 
progress of the disease in a great majority of cases. 



BILIOUS COLIC. 127 

Emetics are more effectual in general, than any other curative 
means in the treatment of bilious colic. Even where the pain 
is wholly confined to the bowels, it is generally relieved by free 
vomiting, together with the relaxation produced by the lobelia. 
In sudden attacks, where the pain is violent, an emetic of the 
third preparation of lobelia, or of lobelia powder and No, 6, must 
be given without waiting to administer the vapour bath. If, 
after the full operation of the emetic the pain continues to return, 
a full course of medicine will be necessary, or the emetics con- 
tinued, together with the application of hot fomentations to the 
abdomen; or the application of hot bricks, wrapped in damp 
cloths to that part. In some cases the emetic v, ill require to be 
frequently repeated. When the patient has warning of the ap- 
proach of the colic, a regular course will be more likely to keep 
it off than a simple emetic without the bath and enema. 

There are many persons subject to periodical returns of bilious 
colic. Such persons are generally dyspeptic, and exhibit marks 
of a torpid liver. I have known several cases of long standing 
effectually cured by an occasional course of medicine, together 
with apropriate intermediate treatment, and strict attention to 
diet. 

The bowels being obstinately constipated, will require the aid 
of injections, more especially if the pain be chiefly in the lower 
bowels. The usual stimulating injections may be used, and they 
always should contain lobelia. In obstinate cases I have wit- 
nessed great relief afforded by introducing a stomach tube, or 
large catheter, eight or ten inches into the bowels, and passing 
an injection through it; the introduction of the tube, however, 
requires care, and sometimes it is difficult to accomplisli it, even 
by tliose who have had experience in the operation. Where the 
abdomen is not very tender to pressure, an injection of spirits of 
turpentine is highly recommended by many practitioners. The 
mode of preparing is to rub together a tablespoonful of turpen- 
tine, and the yolks of two eggs, adding a pint of warm water; 
or mix the turpentine with some dry slippery elm powder, and 
then add the warm water. I have used injections of the lobelia 
powder in warm water, and had the patient to retain them, for 
the purpose of effecting relaxation of the system, which has gen- 
erally been attended with decided benefit. 

The Warm Bath generally affords considerable relief, and 
may be used to prepare the system for an emetic. 

External Applications, — Besides the vapour and warm bath, 
much benefit may be derived by the application over the abdo- 
men of warm stimulating poultices, hot fomentations or mustard 
plasters. The mustard must not be allowed to form a blister. 



128 COLIC A PICTOXUM. 

After the disease is subdued and if the nervous system becomes 
weak and agitated, the valerian, or scull-cap tea may be adminis- 
tered; the latter answers both as a nervine and a tonic. To 
prevent a relapse, the patient should take a dose of spice bitters 
occasionally, or some other warm medicine, and pay strict at- 
tention to diet. 

I do not know of an instance of bilious colic in which the 
Thomsonian practice has failed, when perseveringly applied, 
not only to remove the pain at the time, but in every case a per- 
manent cure has been effected, even where patients have been 
subject to frequent attacks of the disease during a period of from 
two to twenty years. The plan generally to be pursued, is to 
administer an emetic, or a full course of medicine, when there 
are symptoms of a disordered stomach, or of an approaching 
spell of colic. 

Jl Case, — J. M. E. had been subject to attacks of bilious colic, 
and applied to the Homoepathic practice, after the regular treat- 
ment had failed. The Homoepathic medicine gave him almost 
instant relief from the pain, and he continued to use the medi- 
cine whenever the attack of colic come on, until finally the 
spells become much more frequent, and attended with neuralgic 
pains throughout the system. He became alarmed, and placed 
himself under Thomsonian treatment, and by taking a few 
courses of medicine, at proper intervals, and stimulants inter- 
mediately, he was effectually cured. This patient had not more 
than two returns of the spells after the first course of medicine 
was given him. 

The above case illustrates the fact, that although a medicine 
may overcome pain, it may, at the same time not only fail of re- 
moving the disease, but may lay the foundation for another 
form of disease still more troublesome. 



SECTION V. 



COLICA PICTONUM— PAINTER'S COLIC. 

This most distressing malady which has received a variety 
of appellations, such as painter's colic, lead colic, and dry belly- 
ache, is caused by exposure to the fumes, but more particularly 
to the dust of white lead. Painters, and more especially those 
who assist in the manufacture of white lead, are liable to this 
form of disease. 



COLIC A PICTONUM. 129 

Symptoms.— As the system becomes gradually poisoned by 
the metallic substance, the general health is correspondingly 
impaired. There is an uneasy sensation at the stomach; failing 
of the appetite; constipation of the bowels; general debility and 
lassitude; a sense of weight and constriction in the abdomen, 
with transient pains in the stomach and bowels. By de- 
grees the symptoms become more distressing; the pain in the 
stomach and bowels increases; the abdomen is liard, and instead 
of being distended, as in other forms of colic, it is retracted, and 
the natural action of the bowels is suspended. Vomiting almost 
always accompanies this disease; and immediately after vomiting 
the patient experiences more or less mitigation of the pain. 
This disease is not only of an agonizing character, but it is apt 
to be protracted in duration, continuing in many instances for 
two or three days with but slight mitigation of the suffering. 
In the more violent cases the pain extends from the bowels up 
to the chest and into the arms, and downwards to the bladder 
and rectum, accompanied with a distressing sensation of weiglit 
and bearing down, and frequently great difficulty in evacuating 
the bladder. Cold sweats break out over the face and extremi- 
ties; and, in some instances, there is delirium, stupor, and con- 
vulsions. If the disease be not subdued, the vital powers begin 
to sink; the abdomen becomes swollen and puffy, yet with an 
abatement of the pain; the thirst is excessive; the sight is im- 
paired; the feet become swollen; the countenance pale and hag- 
gard; there is difficulty of breathing, and finally the patient 
sinks into a state of stupour terminating in death. 

By a continued exposure to the poisonous influence of lead, 
the vital powers become so far exhausted, as to be insufficient, 
even by the aid of medical means to eradicate the poison from 
the system, and to restore the organs to a healthy condition. Pa- 
tients that have had two or three attacks of painter's colic sel- 
dom recover fully from the effects of the poison. The appetite 
is bad; digestion greatly impaired; the natural temperature of 
the body very low; the extremities always cold; the bowels con- 
tinue obstinately constipated; the spirits sunken and depressed; 
the complexion sallow and of a leaden hue; the flesh wastes 
away; the skin is dry, harsh and contracted; the temper is 
peevish and sullen, and the countenance is expressive of gloom 
and suffering. In the first attack of the disease, however, it is 
almost always curable; though it requires several days in almost 
every instance to effect a favourable crisis in the disease. In 
most instances a cure may be effected, aided by the recuperative 
efforts of nature, during the first attack. 

Treatment — Painter's colic requires the same general plan 
of treatment recommended for the cure of bilious colic. 

R 



150 COLICA PICTONUM. 

The Vapour Bath besides fulfiling other important indica- 
tions, will prove more effectual than any other means used to 
remove the poison from the blood. Besides applying the steam, 
hot poultices composed of pepper and flour, or wai-m fomentations 
should be applied to the abdomen. "When the vapour bath is 
found to afford sensible relief, it may be continued for several 
hours together; the patient being on a bed or mattress, and the 
surface bathed occasionally with whiskey, vinegar or water; 
either cold or tepid, as may be most agreeable to the patient; 
and give occasionally of pepper or composition tea. A poultice 
composed of lobelia powder and slippery elm, wet with No. 6, 
will answer a good purpose. 

Emetics are as essential in this form of disease as they are 
in that of bilious colic, or cholera morbus. In many cases free 
vomiting affords almost the only relief from pain, until the dis- 
ease be subdued. The third preparation of lobelia answers well 
for the emetic, except the tongue be very dry, and the medicine 
occasion a sense of tightness or stricture across the breast; 
when this happens the lobelia powder should be prepared in a 
tea of the bayberry, with the addition of a portion of cayenne 
pepper. Capsicum is one of the best and purest of stimulants, 
and may be given freely in all cases when the secretions of the 
mucous membrane are suspended, occasioning dryness of the 
tongue and throat. 

Injections* — These will be of great service to moderate the 
pain. They may be administered frequently, especially if they 
afford relief. Besides the stimulating kind, an occasional in- 
jection of two or three teaspoonfuls of lobelia powder, given 
in luke warm water, and retained in the bowels will tend to 
overcome the rigidity of the muscles, and alleviate the nervous 
spasms. 

The extreme torpor of the bowels would render tlie utility of 
cathartics, to say the least, extremely doubtful; they would have 
a tendency to harass the stomach, and if not ejected by the sto- 
mach might become absorbed into the blood. The true indica- 
tion of treatment for getting rid of the poison, is to stimulate 
the system, and by this means those organs, designed for re- 
moving deleterious agents from the system will have their cura- 
tive action increased. 

Astringents are especially beneficial in all cases of painter's 
colic. A strong decoction of the compound of the bayberry and 
sumac berries, does better than the tea of the bayberry alone. 
I succeeded in curing a case of the disease that had become 
chronic, the patient liaving been several years employed in Mr. 



DYSENTERY. 131 

Wetheriirs white lead manufactory, where he was daily exposed 
to the deleterious fumes of this noxious mineral. In this case I 
found astringents peculiarly beneficial, administered three or 
four times a day, with the addition of a small portion of capsicum. 

This patient also used injections of the same, and occasionally 
had a vapour bath and an emetic. Large quantities of a thick 
membranous substance were passed from his bowels, 'by the 
injections. 

It must be borne in mind that painter's colic is not to be cured 
in general, short of several days, and in some instances not un- 
der two or three wrecks. 

During the convalescence the patient should take tonics, and 
once or twice a day, a teacup half or two-thirds full of a decoc- 
tion of the bayberry and sumac berries, and avoid exposure to 
the fumes of lead. 

Precautions.— Those engaged in the manufacture of white lead 
should make use of fat meats, or use freely of palm oil at meals, 
and never be exposed to the lead in the morning with an empty 
stomach. A tablespoonful of palm oil taken in the morning is 
said to afford protection to the stomach against the effects of 
this mineral poison. 



SECTION VI. 



DYSENTERYo 



This disease is characterized by severely griping pain in the 
bowels; a frequent inclination to go to stool; and the evacua- 
tions consist of blood and mucous. Sometimes the evacua- 
tions consist chiefly of mucous — at other times they are very 
bloody. 

These dysenteric symptoms are generally preceded by lassi- 
tude, chilliness with flushes of heat, loss of appetite, torpid 
bowels, bad taste in the mouth, and nausea. 

From the commencement of dysentery until there be consider- 
able amendment, the natural faeces of the bowels are retained, or 
voided in very small quantities, consisting of small hard balls, 
called scybalse. The passing of these hard balls through the 
diseased bowels, is attended with severe pain. 

Dysentery prevails most during the latter part of summer, 
and also in autumn. 



132 DYSENTERY. 

Causes.— Perspiration suddenly checked by cold, especially 
where the system is exhausted from over exertion, is a common 
cause of dysentery. **A cold and moist autumn succeeding a 
warm and dry summer, is peculiarly favourable to the produc- 
tion of dysentery. 

Dysentery frequently prevails as an epidemic in low marshy 
districts of country, probably from the continual influence of 
marsh effluvia and dampness. The same causes that produce 
dysentery in one person may occasion bilious fever (as it is 
called) in another; and hence it often happens that both forms of 
disease prevail at the same time, and some patients will have all 
the symptoms of dysentery and bilious fever at once. 

Among the occasional causes of dysentery may be mentioned 
nnripe fruit, and other unwholesome articles of food, taken into 
the stomach. 

Dr. Thomson, in his Narrative, makes mention of a malignant 
form of dysentery which prevailed in the town of Jericho, in 1807, 
wliere out of twenty cases under the treatment of the medical 
faculty, but two recovered. The inhabitants became alarmed, 
and sent an express for Dr. Thomson, who began to treat the 
disease according to his system of practice, and of thirty cases 
which came under his treatment, all except two recovered. *^I 
had," says the doctor, *^but little medicine with me, and had to 
make use of such as I could procure at this place. I found the 
cause of the disease to be coldness and canker; the digestive 
powers being lost, the stomach became clogged, so that it would 
not hold the lieat. I made use of red peppers, steeped in a tea 
of sumac berries, and sometimes the bark and berries, to raise 
the heat and clear off the canker, which had th'e desired effect 
After taking this tea, those who were strong enough I placed 
over a steam, as long as they could bear it, and then put them 
in bed. Those who were too weak to stand, I contrived to have 
set over the steam, and this repeated as occasion required." 
To restore digestion, the doctor made use of a syrup made of 
black birch bark and cherry stones bruised. 

Treatment of Dysentery. — Dr. Thomson's course of medicine 
fulfils all the necessary indications in the cure of dysentery.— 
The course should be repeated daily in bad cases. 

During the intervals between tlie courses of medicine, or 
when the disease is of a mild form, not requiring a course of 
medicine, any one of the following preparations may be given at 
intervals of one or two Iiours, viz : 

A strong decoction of bayberry or of bayberry and sumac, 
adding a portion of cayenne pepper, and sweetened; or the pepper 
alone in tea or in pills, with an occasional dose of the above 
decoction* 



DYSENTERY. 133 

Another preparation, — Composition powder and sugar, each a 
teaspoonful, rub them together, and add a teacup half full of 
hike- warm water, to be stirred together before taken. Prepared 
in this way the composition has a better effect than when scald- 
ed in boiling water. 

Another. — Take of fine bayberry powder and sugar, each a 
teaspoonful, add two teaspoonsful of No. 6; mix them together, 
and, if preferred, a wineglassful of hike-warm water may be 
added, or to half a pint of No. 6 add a tablespoonful of finely 
powdered bayberry, shake the mixture eccasionally, and for a 
dose take a teaspoonful, with a teaspoonful of sugar; this may 
be taken with the addition of a portion of bayberry tea. 

For children and delicate females, milder preparations may 
answer, such as bayberry tea well sweetened, adding to it a por- 
tion of the composition powder; or a simple tea of the bayberry, 
or composition well sweetened. 

The Vapour Bath is signally beneficial in dysentery, and may 
be frequently administered; and will afford much relief to the 
patient. After the bath and the patient is rubbed dry, apply 
stimulating ointment, the third preparation of lobelia, or No. 6, 
over the surface. Bottles of hot water or hot bricks, wrapt in 
damp cloths, should be kept to the feec and abdomen. 

As a substitute for the vapour bath, in mild cases, wrap the 
body, from the hips to the arm-pits, with a bandage of flannel. 
The constant application of warmth and pressure, is of great im- 
portance, and well adapted to all cases of bowel complaints, 
both acute and chronic. The flannel roller should be applied 
even when the vapour bath is administered, and also when the 
patient goes to stool, in order to protect the body from the air. 

Injections. — The inflammation that exists in dysentery is the 
result of the reaction of the constitution to overcome the debility 
or loss of vitality of the parts. Injections assist the healthy ac- 
tion, and remove acrid secretions. They should be composed 
of astringents and stimulants. A strong decoction of bayberry, 
dewberry root, or raspberry leaves, adding a teaspoonful of the 
liquid of the third preparation of lobelia, to half a pint of the 
tea; or scald a teaspoonful of pepper with the other articles; add 
a teaspoonful of lobelia powder, and stir the mixture. Lobelia 
in some form, either the powder or liquid of the third prepara- 
tion, should generally be added. A large teaspoonful of lobelia 
powder infused in half a pint of warm water, or half a pint of 
composition tea, may be used in place of the more stimulating 
injections. 

When the stools are very offensive, the purified charcoal 



1 34 DYSENTERY. 

should be added to the injections, and also given occasionally 
with the medicine otherwise taken. In the place of the charcoal 
the chalk mixture may be used; or the bi-carbonate of soda or 
salseratus. 

The chief objection to frequent injections, is the irritation pro- 
duced by the metallic pipe of the syringe. It should be well 
covered with oil or tallow; or a gum elastic tube made for the 
purpose, placed on the metallic pipe. 

Professor Chapman, in a lecture on dysentery, in 1840, stated, 
that at Vera Cruz, the only successful treatment in the malig- 
nant dysentery that prevailed there, consisted of giving the pa- 
tients freely of cayenne pepper tea, and using injections of the 
same. 

A case of dysentery occurred in Chester county, of the most 
severe character, in which a quarter of a pound of cayenne pep- 
per was used by injection and given in tea during one night, 
together with a large quantity of the hot drops, and bayberry 
tea. The patient speedily recovered, and no doubt by means of 
this energetic treatment. 

Diet — This must be of the lightest kind of food, such as bar- 
ley water, arrow root gruel, weak chicken tea, sago, rice, slip- 
pery elm, Iceland moss, the bene plant, &c. When the patient 
becomes convalescent, stronger food may be given, as boiled 
chicken and wild game. 

To assist in restoring digestion, the spice bitters and other 
tonics may be employed. 

Favourable Symptoms, — **The appearance of bile, and natural 
fjeces in the stools, indicate a favourable change." When the 
pain, and inclination to stool, *^and tenderness of the abdomen 
abate, at the same time that the skin is uniformly moist, we may 
regard the case as approaching a state of convalescence; and 
more certainly if the stools assume a more natural appear- 
ance." 



SECTION VII. 



DIARRHOEA— RELAX. 

This complaint is a consequence of indigestion. It prevails 
most during hot weather, and presents in different cases, great 
diversity of character, being in some instances an obstinate and 
painful disease, and in others a slight affection. Children are 
extremely liable to this form of disorder throughout the hot 
summer months, and also in the damp and changeable weather 
of autumn. 

General Causes. — Diarrhoea may be produced by any cause 
which weakens the power of digestion. The usual causes are 
continued spells of damp, murky weather; wearing damp clothes; 
a sudden check to perspiration, when the system is exhausted by 
fatigue; unwholesome articles of food, especially sour fruit; and 
drinking too freely of cold liquids, as ice water or lemonade. 

Symptoms. — At first there is usually loss of appetite, general 
debility, coldness of the feet, and bad taste in the mouth. The 
patient experieiices unpleasant sensations at the pit of the sto- 
mach: there is generally a rumbling tiirough the bowels, followed 
by copious evacuations, consisting of thin offensive secretions, 
and imperfectly digested food, and frequently attended with 
pain. The skin is either cool and clammy, or dry. When the 
disease comes on suddenly and is attended with vomiting, it is 
called cholera morbus. The colour of tlie stools in many in- 
vStances, is light, indicating a want of bile: in other instances 
they are partly composed of vitiated bile. 

Diarrhoea, Bysentery, and Cholera Morbus, may arise from the 
same cause, or combination of causes. 

Bistinguishing Marks between Biarrhoea and Bysenfery. — In 
diarrhoea the bowels are in a relaxed condition, with copious 
evacuations, consisting chiefly of imperfectly digested food, and 
generally free from blood or mucous. In dysentery the bowels 
are costive, the natural fseces retained, and the stools consist 
principally of blood and mucous, small in quantity, and the dis- 
ease is attended with severe griping, and a frequent inclination 
to go to stool. 



136 DIARRHCEA — RELAX. 

Treatment of Diarrhoea.— In slight cases, a few closes of com- 
position or bayberry tea, with the addition of No. 6, will, in gen- 
eral, check the disorder, and correct the digestion. A variety 
of other remedies may be nsed for this complaint, such as cho- 
lera syrup, Thomson's No. 5 syrup, lavender brandy, burnt 
brandy and loaf sugar, cbalk mixture, lime water, and purified 
charcoal. Salt and water is a remedy in many families. 

When the symptoms are more distressing, or the case proves 
obstinate, the most effective means will be a fidl course of 
medicine.) succeeded by the use of the hot medicine, and the pa- 
tient kept comfortably warm and quiet. 

In the commencement, in many instances, but more especially 
when the disorder has been checked, bitters should be used to re- 
store digestion. 

Flannel Bandage. — Persons subject to frequent attacks of 
diarrhoea, may derive great benefit by wearing a flannel band- 
age covering the whole of the abdomen. This will keep the 
skin regularly warm, and prevent a sudden check to perspira- 
tion from the vicisitudes of the weather. This simple plan of 
bandaging the belly, will generally prevent the summer com- 
plaint in children, even during their second summer, provided 
they be bathed daily, and a proper attention paid to their 
€liet. 

>yhen the disease becomes protracted, and tlie symptoms dis- 
tressing, a prompt course of treatment should be pursued until 
the disease be removed. The vapour bath and emetics should 
be repeated as the nature of the case may require. In cases of 
children I have frequently witnessed more benefit derived by one 
vapour bath and an emetic, than would have been accomplished 
probably in two or three days under a mild course of treatment. 
When medicine has to be forced upon cliildren it is certainly best 
to give such as will be the most eftectual to break up the dis- 
order. 

Let the No. 3, or bayberry powder be made into a strong de- 
coction, and to a teacup half full of this tea, add an even tea- 
spoonful of composition powder. This given two or three times 
a day, will be an effectual remedy in most cases of simple diar= 
rhcsa. The No. 3 pills may be used in place of the decoction. 

Injections of the above tea, adding a portion of No. 6 and green 
lobelia, or a teaspoonful of the third preparation of lobelia, will 
be found especially beneficial to strengthen the bowels. 

Die^.— Especial attention to diet is necespary in all bowel 
complaints. In general, milk porridge, well prepared, will 
agree well with the stomach, and in some cases will check the 



PERITONITIS. 137 

disorder, by confining the diet to it alone, or with tlie addition 
of stale bread cut thin and toasted thoroughly, or soda or water 
crackers. Fruit of every description is apt to disagree witli the 
bowels in diarrhoea, unless it he fresh picked, and eaten with 
some solid food. 

Boiled rice and milk, Bermuda arrow root, elm gruel, sago, 
tapioca, fresh eggs slightly cooked, essence of beef, boiled cliicken, 
crust coffee, and Irish moss, are such articles as are generally 
adapted to cases of diarrhoea. Rice scorched, ground, and made 
into coffee is a favourite remedy with some for this complaint. 

I have known cases of chronic diarrhoea cured by a free use 
of capsicum at meals. 



SECTION VIII. 



PERITONITIS, 

(inflammation of the PEEITONEtJM.) 

Disease of the peritoneum (the membrane lining tlie cavity 
©f the abdomen, and which also forms the external coating of the 
bowels) is not of very frequent occurrence: when it does take 
place, however, it is in many instances extremely difficult to 
cure, unless a vigourous and persevering course of treatment be 
instituted in the first onset of the disease. 

Causes. — Long exposure of the body to cold after fatiguing 
exercise, is the usual cause of peritonitis. It may arise, also, 
from other causes, as taking too freely of ice water; mechanical 
injuries of the bowels; the escape of fgeces into the cavity of the 
belly from wounds of the intestines, or by ulceration through the 
coats of the bowels; v/et and cold feet; and, in females, from bad 
management during, or after confinement. In two fatal cases 
that came under my notice, one was brought on by washing the 
body in cold water, the patient remaining undressed until the 
body became completely chilled : the other case was produced 
by standing some hours in cold water, up to the middle, in a 
well. 

Symptoms. — The first symptoms are such as usually occur in 
the commencement of other forms of disease, such as chilliness, 
lassitude, pain in the limbs, and distress at the pit of the sto- 
mach. In some instances an acute pain is felt in ^some part of 

S 



138 PERITONITIS. 

the belly, from the commencement. In other instances, and 
even those of the most rapidly fatal character, there is scarcely 
any pain felt during any period of the disease. 

The Symptoms which Characterize this Disease, are extreme 
tenderness to pressure over the surface of the abdomen, and the 
patient assumes a bent posture in order to relax the muscles of 
the belly; with constipation of the bowels, and pain of an acute 
character, generally confined at first to a small space, and spread- 
ing gradually, and sometimes shifting suddenly from one spot 
on the belly to another. In most instances there is at the com- 
mencement of this disease, and always in the latter stage, if the 
disease terminate fatally, more or less vomiting. The counte- 
nance is pale, and expressive of extreme anxiety and distress. 
** Generally, in the course of from twenty-four to thirty-six 
hours, the abdomen becomes swollen, tense, and elastic from 
flatulent distention of the intestines, and extremely tender. Re- 
spiration is oppressed and laborious in the latter period of the 
disease; inspiration especially, being short, difficult, and attend- 
ed with an expression of pain in the countenance. The secre- 
tion of urine is almost invariably more or less diminished, and 
in some instances, almost wholly suppressed. "When the peri- 
toneal coat of the bladder is the seat of inflammation, the evacu- 
ation of urine will almost uniformly be suspended, and much 
pain felt in the pelvis. The peritoneal covering of the inferior 
surface of the diaphragm is occasionally the principal or sole 
part of this membrane that is inflamed, and in this case almost 
constant hiccough attends. 

In most instances the peritoneal inflammation terminates by 
the sixth or seventh day, either in resolution, or fatally. In 
some cases its course is much more rapid, the patient sinking by 
the second or third day from the commencement. Occasionally 
however, the disease is prolonged to the thirteenth or fourteenth 
day. 

This disease is extremely liable to terminate in gangrene. 
** When this occurs, the abdominal pain suddenly subsides; the 
pulse becomes very small, frequent, and often intermitting; 
great muscular prostration ensues; the extremities become cold 
and clammy; and the countenance pale, hollow and contracted;" 
there is a sort of gulping up of the liquids when swallowed, and 
usually more or less delirium. 

When peritoneal inflammation ensues after confinement (con- 
stituting puerperal fever) the louchial discharge ceases, and the 
secretion of milk is suspended, or nearly so. Under such cir- 
cumstances the disease is mostly rapid in its course. 

Treatment, — There is probably no form of disease requiring 



PERITONITIS. 1S9 

more vigorous treatment than peritonitis. The first and most 
important remedy is a vapour bath, which should bfe continued 
for hours together; the patient being on a cot or mattress, if too 
weak to sit up; and at the same time frequent and full doses of 
the third preparation of lobelia should be given, together with 
lobelia injections, composed simply of lobelia powder in luke- 
warm water, and retained, if possible; and as often as every 
hour or two, an additional injection, consisting of a tablespoonful 
of the liquid of the third preparation of lobelia in bayberry tea. 
In place of the vapour bath, blankets wrung out of hot water, 
may be applied to the abdomen, or a large poultice composed of 
elm powder, green lobelia and ginger, applied all over the 
belly, as hot as can be borne, and to be kept warm by bottles of 
hot water or hot bricks placed close to it, or it may be taken off 
and warmed when necessary. 

It is important to relax the system in the early stage of the 
disease, by giving besides the third preparation of lobelia, fre- 
quent doses of an infusion of the brown lobelia. The more the 
system becomes relaxed by the lobelia in the early period of the 
disease, the greater will be the chance for the inflammation to 
establish a favourable crisis. 

When a favourable crisis takes place, and the system sinks 
into a state of extreme exhaustion, as is frequently the case, 
more especially when the disease occui's in the puerperal state, 
diffusive stimulants should be employed, as wine whey, carbo- 
nate of ammonia, the third preparation of lobelia, capsicum tea, 
&c. 

^* There is a period in some cases of abdominal inflammation 
when the disease is nearly subdued, yet a tendency to gangrene 
exists from deficiency of vital power. At such a time the pain 
will vanish, the pulse become weak, the vital powers sink, and 
a coldness overspread the body. These symptoms are too often 
indicative of mortification; but every experienced practitioner 
must have occasionally witnessed cases of recovery even from 
this alarming state." Therefore the free use of stimulants under 
these circumstances, may have the effect to turn the scale in fa- 
vour of recovery, and even if mortification should have taken 
place stimulants can do no injury. 



SECTION IX. 



CONSTIPATION— COSTIVENESS. 

Costiveness, in general, is a consequence either of diminished 
peristaltic action of the howels, or of a torpid liver* The hahitual 
use of purgative medicines destroys the natural tone of the bowels, 
and thus proves one of the most common causes of constipation. 
A patient becomes uncomfortable in consequence of the slugglish 
state of the bowels, and a dose of physic is taken* In a few 
days, however, the same bad feelings return with loss of appe- 
tite, furred tongue, and bad taste in the mouth; there is heavi- 
ness and languor, and oppression at the stomach. The patient 
supposes he is bilious, requiring another dose of physic to 
purge off the accumulation of bile, and in this w^ay continues 
its use at frequent intervals, harassing the stomach and destroy- 
ing the natural action of the bow^els. Costiveness is sometimes 
constitutional^ and in general it arises from causes which de- 
press the nervous energy, such as sedentary habits, foul air, in- 
temperance, or all kinds of deleterious medicines, whether mine-- 
ral or vegetable. The practice of giving anodynes to infants 
weakens the tone of their howels, and in numerous instances the 
foundation of habitual costiveness is laid. It is very common 
in the old practice for a physician to recommend laudanum, or 
some other preparation of opium, for children and infants when 
sick, and on the following day prescribe a dose of oil to move 
the bowels, which had become torpid in consequence of the ano- 
dyne; the physic disturbs the stomach and impairs digestion; 
and the little patient consequently becomes fretful; another dose 
of anodyne is administered, which benumbs the sensibility of the 
nervous system, and the child sleeps, but the medicine instead 
of removing the disease, rather increases the diflSculty; costive- 
ness continues, and another cathartic is prescribed, and thus one 
medicine is given to counteract the bad effects of the other. 
Not only is such a course generally pursued in the treatment of 
infants and children, but a similar one is resorted to by many 
pliysicians in the majority of cases of sickness, in adults that are 
placed under their care. It is very rare to find a person affect- 
ed with obstinate constipation of the bowels who has never been 
in tlie practice of taking cathartics. 

There are persons constitutionally costive, whose bowels are 
not moved oftener than once a week, and yet the general health 



COXSTIPATIOir. 141 

remains good. Such instances, however, are very rare, for 
most persons feel more or less uncomfortable without an evacu- 
ation as often as once in twenty -four or forty-eight hours. 

Means to Remove Costiveness. — There is a great diversity of 
remedies and means to restore tlie action of the bowels. 

Ji Proper Diet — Certain articles of food will in a great many 
instances keep the bowels regular, such as stale bread, or gruel 
made of ground wheat, unbolted, Indian bread, ripe fruit, rye 
mush, oat meal gruel, and calves' foot jelly. No certain plan 
of diet can be proposed that will suit everyone. Bread made 
of unbolted wheat flour will probably agree with almost every 
one, and its efficiency has been so well attested as not to admit 
a doubt of its efficacy. I have known obstinate cases of con- 
stipation overcome by the free use of a gruel made of the un- 
bolted flour, together with the use of cayenne pepper, and the 
entire absence of every kind of cathartic. In the use of tiie un- 
bolted bread or gruel, other kinds of food need not be excluded. 
Animal food is necessary to the health of some, and should be 
used when it agrees with the stomach. Beef, mutton, and all 
kinds of wild game are as readily digested as vegetables. 

Charcoal, — Finely pulverized charcoal, taken in large tea- 
spoonful doses, repeated three or four times a day, is a valuable 
remedy for costiveness, especially when constipation is accom- 
panied by a sour stomach and heartburn. Costiveness arising 
from pregnancy, may in most instances be removed by the free 
use of charcoal. In the latter stage of pregnancy, however, it 
is sometimes necessary to resort to the use of stimulating enemas, 
in order to evacuate the bowels. The charcoal should be first 
moistened and rubbed into a paste, and it will then mix readily 
with liquids. I generally direct it to be taken in composition 
or spice bitters tea. It may be taken, also in simple warm 
water, or in boiled milk. The dose is from a teaspoonful to a 
tablespoonful, repeated three or four times a day before meals. 

WTiite Mustard Seed is a favourite remedy used by many to 
stimulate the bowels, and overcome costiveness. The usual dose 
of the mustard seed is a tablespoonful once or twice a day, taken 
in warm water or molasses. 

Capsicum. — This is one of the purest and best of stimulants, 
and is especially beneficial in most cases of torpid bowels. Taken 
freely at meals, it will not only assist the action of the bowels, 
but will be sufficient, if used freely, to cure many cases of dys- 
pepsia. There are many kinds of food that may set well on the 



142 COlSrSTIPATION. 

stomach, if highly seasoned with cayenne, hut which without it 
would occasion oppression, and distress the stomach. Those 
who do not relisli food highly seasoned with pepper, may take 
the cayenne immediately after eating, in a little cold water, or 
as some prefer, swallow the whole pods of the bird-pepper. 
These pods are not thicker than a small goose quill, and scarce- 
ly ever an inch in length, so that half a dozen may be swallowed 
at a time, and no burning produced in the mouth. Ten or 
fifteen of these pods taken daily will be sufficient, in general, to 
keep the bowels regular. 

Astringents. — When the tongue is thickly furred, and not dry 
or parched, the astringents recommended by Thomson will be 
useful by cleansing the cankered bowels and increasing their tone. 
The best astringent is the bayberry, or a compound of bay- 
berry and sumac. The No. 3 pills may be used in place of the 
above powder in decoction. Injections assist very much in 
cleansing the bowels of morbid secretions, and also have a ten- 
dency to increase their tone. 

Bitters. — Vegetable bitters are particularly indicated when 
the system is relaxed, as in recovery from sickness when the 
bowels remain torpid. A teaspoonful of barbary powder taken 
two or three times a day will be sufficient to keep the bowels 
regular, in those cases where tonics are indicated. The golden 
seal, balmony, or black aspen poplar may be employed for the 
same purpose. In continuing the use of tonics it is proper tof 
change one for another, or to compound them differently every 
few days. 

Injections should be used occasionally until, by other means, 
the natural action of the bowels be restored. When constipation 
is attended with piles, an injection of a strong decoction of the 
witch hazle, at bed time, retained in the bowels until morning, 
will in general procure a passage from the bowels, and also 
assist in curing the piles. 

Cleanliness, exercise in the open air, the warm bath, the 
shower bath, the daily use of the flesh brush or salted towel over 
the surface, and wdiatever else will invigorate the nervous sys- 
tem, will have a salutary effect upon digestion, and assist the 
peristaltic action of the bowels. 

The habit of soliciting a stool at a certain hour daily, more 
especially in the evening, though it may fail at first, if per- 
severed in, will generally prove successful. 

Three or four of the compound lobelia pills, taken at bed time, 
have proved successful in many cases, in regulating the bowels, 
and in promoting the secretion of bile. 



SECTION X. 



DYSPEPSIAS-INDIGESTION. 

Digestion is accomplislied by a series of actions extremely 
complicated, liable to derangement from various causes. Hence 
dyspepsia is a common complaint, and prevails in all classes of 
society. 

Causes — Dyspepsia in many instances is a consequent of 
original feebleness in the constitution. Apart from this, the fol- 
lowing are among the common causes of indigestion. 

1. Exposure to Cold and Dampness— especially Damp Feet— 
This is a common cause of dyspepsia in the country during damp 
seasons of the year. 

2. Tobacco. — The inordinate use of this article is a fruitful 
source of dyspepsia. It causes imbecility of mind, and in some 
instances, melancholy. 

3. Purgative Medicines, — The long continued use of cathartics 
impairs the functions of tlie stomach and bowels, and in frequent 
instances, where there is but slight derangement in the stomach 
at first, ^^the drugs are poured down,'^ and the case becomes 
one of confirmed dyspepsia. 

4. Anodynes. — All the various preparations of opium, such as 
laudanum, Godfrey's cordial, 6cc., enervate the stomach, and 
weaken the power of digestion. Hence Dyspepsia often takes 
place in childhood by the prevailing practice of giving anodynes 
during infancy. 

5. Sedentary Habits. — Persons engaged in sedentary pursuits 
— seamstresses, shopkeepers, shoemakers and tailors, are liable 
to dyspepsia, especially when confined to small and ill-ventilated 
apartments. 

6. Unwholesome Food. — Many wlio by a proper diet might 
have enjoyed good health, are tormented with indigestion, in 
consequence of the use of food difficult to digest, such as hot 
bread, fresh pork, hot cakes, sausages, pies, &c. Hearty sup- 
pers, especially of such food as sausages, hot cakes, and strong 
coffee, cause restless and disturbed sleep, frightful dreams, and 
nightmare. 



144 DYSPEPSIA. 

7. Blood-letting,- — Many cases of dyspepsia may be traced to 
the profuse depletion frequently practiced by physicians in pleu- 
risy, and in the various forms of acute disease attended with 
higli fever. The system becoming exhausted from loss of blood, 
the organs are left in a languid condition, incapable of perform- 
ing their functions properly, and in many instances occasion 
confirmed dyspepsia. 

8. Mercury, — Professor Chapman asserts that the majority 
of cases of chronic affections of the liver prevalent in the South- 
ern states, is owing to the inordinate use of mercury, it being a 
practice among the physicians to administer it in enormous 
doses. Digestion never can be properly performed whilst the 
liver is diseased, and therefore, all such cases are more or less 
dyspeptic. 

9. Intemperance is a fruitful cause of dyspepsia. The prac- 
tice of taking a morning dram, which prevails in some districts 
of country is usually followed sooner or later by indigestion. 

10. Mstinence may be practiced too rigidly to be compatible 
with health, and it may even produce dyspepsia. The exclusive 
use of a vegetable diet, together with cold water at breakfast and 
supper, in the place of good tea or coffee, is calculated to ener- 
vate the stomach. 

There are cases in which an exclusively vegetable diet suits 
the stomach, but with the great majority of mankind, animal 
food, such as beef, mutton, or wild game, will be found more 
easy of digestion than a vegetable diet. 

11. Bad Teeth — Irritation of the gums arising from teeth 
that arc either decayed or affected with tartar, is a frequent 
cause of dyspepsia. 

A lady from Natchez consulted professor Chapman for dyspep- 
sia of long standing, and the doctor perceiving the bad condition 
of her teeth, suspected this to be the cause of the dyspepsia; the 
decayed stumps were removed, the mouth put in good condition, 
and the dyspepsia was soon cured. Subsequently this lady had 
a new set of teeth put in, but which being badly done, the dys- 
pepsia returned with great violence. The teeth where removed, 
and by being properly adjusted, so as not to irritate the gums, 
she was soon restored to perfect health. 

12. Tiles often produce dyspepsia, and in many instances the 
dyspepsia may be cured by their removal. 

13. Moral Impressions, — From the close sympathy existing 



DYSPEPSIA. 145 

between the brain and stomach, moral impressions have a con- 
trolling influence over digestion. If a man, soon after eating a 
hearty meal, hear bad news, his digestion will at once be weak- 
ened, if not suspended. Close application to study soon after 
meals, by concentrating the nervous energies in the brain, weak- 
ens the power of the stomach to perform digestion. 

In fine any cause that weakens the nervous energy, impairs 
the digestive functions: hence venereal excesses are a common 
cause of dyspepsiai 

It is a general impression that dyspepsia prevails most among 
the higher ranks of society, and that tlie poor, notwitlistanding 
their hardships, are generally blessed with vigorous digestion. 
The great majority of cases of dyspepsia that I have met with, 
have been among the hard labouring classes, more especially in 
those whose business required them to be indoors, as cotton and 
woollen manufacturers, weavers, shoemakers, tailors, &c. The 
wealthy pay greater attention to bathing, they sleep in large and 
airy rooms, and partake of the best of food. 

Symptoms of Dyspepsia. — A low temperature of the body; op- 
pression, tenderness, and distress at the pit of the stomach; tor- 
pid bowels; heart-burn; frequent belching; sour eructations; 
offensive breath; and often some degree of fever or excitement 
after meals. In some instances tlie appetite is irregular, or de- 
praved, craving green fruit; sometimes the appetite is entirely 
gone; the spirits are variable, and frequently depressed. 

In the more aggravated form of dyspepsia, the mind is liable 
to become much depressed, approaching in some instances to 
extreme melancholy, with harassing belchings; water brash; 
stools clay coloured, indicating the abserice of bile, the skin is 
dry and husky, yet sometimes cool and clammy; there is wast- 
ing of the flesh and ulceration of the tongue and mouth. Pain in 
the head, palpitation of the heart, dizziness and temporary blind- 
ness, and violent pains in the shoulder and side, are symptoms 
frequently attending dyspepsia. 

Sometimes in dyspepsia the sensibility of the stomach is so 
obscured that the derangement of the digestive organs is scarce- 
ly perceived by the patient, the principal symptoms being devel- 
oped in parts remote from the stomach, where sensibility is more 
acute. Such is the degree of insensibility in the stomach, that it 
may become diseased and give rise to almost every variety of 
disorder without any particular symptoms of derangement being 
manifest in its own peculiar region. 

Disorders produced by Dyspepsia, — Dyspepsia long continued, 
not unfrequently brings on consumption, especially when there 
is constitutional weakness of the lungs. 

T 



■M 



146 DYSPEPSIA. 



Many, if not most of the cases of bronchitis, are a secondary 
effect of dyspepsia. Clergymen are very liable to disease of the 
throat, occasioned more by mental labour soon after meals, than 
by their public speaking. 

The liver possessing a close sympathy with the stomach, be- 
comes torpid and inactive in many instances, in consequence of 
the cold and weak condition of the latter. More especially does 
this occur in the intemperate. 

Bilious colic and sick headach are brought on in consequence 
of bad digestion. 

Tetter is hot unfrequently dependent upon indigestion, and 
in some instances cannot be cured until the stomach is cleansed, 
and digestion restored. 

Jsthma is generally connected with dyspepsia. 

The stomach, in fine, possessing a controlling influence over 
the functions of the various organs of the body, may, by having 
its powers enfeebled, bring on an endless variety of disordered 
symptoms in other parts. More especially is the train of evils 
resulting from dyspepsia multiplied and aggravated when the 
stomach is harassed by tlie use of cathartics, anodynes, and 
other deleterious drugs. 

Treatment of Byspepsia, — Dr. Thomson's course of medicine, 
administered at proper intervals, as the symptoms indicate, to- 
gether with proper intermediate remedies, will effect a cure in a 
great majority of cases. If the continuance of the disease de- 
pend upon bad habits^ a cure cannot reasonably be looked for 
w^hilst they are continued. 

If close confinement in uuhealthy apartments be tlie cause of 
dyspepsia, exercise and fresh air will be as essential as medi- 
cine. 

When dyspepsia arises from a bad condition of the teeth, they 
sbould be attended to by the dentist, and by one wbo is properly 
acquainted with his profession. 

Purgative medicines impair the tone of the stomach, leaving 
the bowels costive, and therefore should be dispensed with in 
dyspepsia. 

Emetics. — An emetic of lobelia, prepared in the usual form, 
will sometimes relieve the stomacb sufficiently without the ne- 
cessity of a full course of medicine. 

To promote a healthy action of the skin, an occasional vapour 
bath, or warm bath, and the daily use of the flesh brush or salted 
towel, will be the most effectual means. 



DYSPEPSIA. 147 

Capsicum. — The free use of cayenne pepper at meals, will be 
sufficient to cure dyspepsia in many instances. It is useful to 
prevent heart burn and water-brash, and has a tendency to re- 
gulate the bowels. 

Composition Fowder. — Dyspepsia of a mild character may be 
cured by taking a dose of composition two or three times a day. 
When the patient is exposed to the weather it is best not to pre- 
pare the composition in boiling water, but first mix the powder 
with sugar, and then add half a teacup of luke-warm water, stir 
the mixture well and swallow it before it settles. 

The Spice Bitters may be taken in the same way, and for the 
same purpose. 

The Conserve of Hollyhock is a mild stimulant and tonic, and 
useful in cases of feeble digestion. It is a convenient medicine 
for persons travelling. 

Charcoal, — Purified charcoal being an absorbent and anti-sep- 
tic, and operating as a mechanical stimulant to the bowels, may 
be used with advantage in cases of sour stomach, attended with 
costiveness. The dose is a large teaspoonful to be rubbed up with 
about an equal quantity of sugar and water, and then add a tea- 
cup two-thirds full of a tea of composition or spice bitters, taken 
on an empty stomach, and repeated two or three times a day. 

In dyspepsia accompanied with a pale tongue, relaxed skin, 
and general debility, stronger tonics must be used, such as Dr. 
Thomson's No. 4 bitters, quassia, w^ormwood, &c. either pre- 
pared in decoction or in tincture. 

AVhen there are symptoms of dyspepsia with extreme insensi- 
bility of the stomach, benefit may be derived from mechanical 
means, as riding on a rough trotting horse, or in a rough car- 
riage after dinner, or punching or kneeding the stomach as dis- 
covered and introduced by a Mr. Hallstead of New York, w^ho 
was cured of dyspepsia attended by extreme insensibility of the 
stomach, by making a false step, by which his stomach received 
a severe jar. 

Alkalies. — Where there is a large amount of offensive gas 
ejected, either upwards or downwards, the use of lime water 
will be beneficial. 

In cases of simple acidity of the stomach, the super carbonate 
of soda» or salseratus, will neutralize the acid. Chalk may be 
used for the same purpose, and in some instances will have a 
better effect than soda or sal^ratus. 



148 DYSPEPSIA. 

The following was a favourite remedy with the late Dr. Phy- 
sic of this city. 

Take a quart of hickory ashes, and a teacupful of com- 
mon soot, pour on them a gallon of boiling water. The 
dose a wineglassful after meals. 

A decoction of wormwood and hickory ashes fulfils the pur- 
pose both of a tonic and anti-acid. 

In some cases of dyspepsia, acids will be found to be more 
beneficial than alkalies, even though there should be acid in tlie 
stomach. A mixture of vinegar, salt, and pepper, will be of 
benefit in many cases. From ten to thirty drops of the elixir of 
vitriol, in a wineglassful of water, or of bitter tea, tliree or four 
times a day, will be grateful to the stomach, and assist diges- 
tion. 

A tablespoonful of dry wheat bran, two or three almonds, or 
a teacupful of boiled milk, will relieve heartburn. 

Colic, — Dyspeptics are liable to cholicky pains, from an accu- 
mulation of gas in the stomach, which may generallybe relieved 
by Thomson's No. 6, or the volatile tincture of guiacum, given 
in hot w ater, composition or pepper tea, and swallowed as hot as 
the patient can bear. The oil of amber, spirits of turpentine, or 
oil of juniper may be used for the same purpose. Ten drops of 
the oil of amber, rubbed up with sugar, and mixed with a small 
quantity of slippery elm mucilage, will sometimes remove the 
severest forms of colic, especially when the stomach is very 
weak. When the case is very severe, the vapour bath, followed 
by an emetic of the third preparation of lobelia, will be the 
surest means of relief. 

Pain in the Bowels, — This may generally be removed by in- 
jections. A stomach tube, or large gum elastic catheter, intro- 
duced eight or ten inches into the bowels, and the injection 
passed through it, will give relief in cases where the injections 
given in the usual way have little or no effect. Great benefit 
may be derived from hot fomentations, or a warm poultice ap- 
plied to the abdomen. 

Costiveness, — A torpid condition of the bowels exists in most 
cases of dyspepsia, and in many instances it is diificult to over- 
come, where purgatives have been freely used. Bran bread, or 
bread made of unbolted wheat Hour, is an excellent remedy for 
costiveness. Cayenne pepper, or pepper sauce, used freely at 
meals, or immediately after eating, will assist digestion, stimu- 
late the bowels, and frequently be sufficient to overcome the con- 



DYSPEPSIA. 149 

stipation. Clean wheat bran, charcoal, and white mustard seed, 
act as mechanical stimulants to the bowels, and may be used ac- 
cordingly. Injections may be used to evacuate the bowels when 
necessary, until by a proper course of treatment, and a well- 
regulated diet and regimen, tlieir natural action become restored. 
Avoid aggravating the bowels by the use of cathartics, as it will 
be difficult for the bowels ever to recover their natural tone and 
action, as long as the patient continues to take every week, or 
every few days, a dose of cathartic medicine. 

Diet in Btjspepsia, — No system of diet can be laid down, suited 
to every case of dyspepsia. 

Milk generally agrees with dyspeptics. Milk porridge, boiled 
milk and rice, Indian musli, well boiled, allowed to become cold, 
and eaten with boiled milk, and boiled milk and toast, are suit- 
able articles of diet in most cases of dyspepsia. More especially 
is a milk diet proper for the morning and evening meal. Milk, 
when taken cold and in large quantities, sometimes forms an in- 
digestible mass, of a cheese-like substance, occasioning great 
oppression at the stomach. 

As a substitute for milk when it disagrees with the patient, 
cocoa or chocolate, black tea, or what is better, the anti-dyspep- 
tic cocoa, prepared by A. Comfort, of Philadelphia, may be used. 
In some cases of dyspepsia, coffee, well prepared, maybe taken, 
iiot only with impunity, but with advantage. Much of the evil 
arising from the use of coffee, is owing to the bad quality of tlie 
article, and to the careless manner in which it is frequently 
roasted and prepared. 

Of animal food, all kinds of wild game when in season, eggs, 
chicken, turkey, fresh beef and mutton, are the most digestible. 
Salt pork agrees with many. Fresh pork disagrees with the 
dyspeptic in almost every instance, yet, notwithstanding, some 
cases have been cured by eating broiled^resh pork, although such 
cases are very rare. In some, animal food of every description 
will disagree with the stomach. All kinds of soups are objec- 
tionable from their liability to sour in the stomach; though in 
small quantities they may not disagree with it. There is not 
the same objection to essence of beef, as to soups. 

Bread made of unbolted wheat flour has become a favourite 
article of diet for dyspeptics, and answers well in the majority 
of cases. Toasted bread agrees well with many. It should be 
cut in thin slices and toasted through, so as not to have it doughy 
in the middle. Bread should not be eaten until at least twelve 
hours old. Hot cakes sliould be avoided. Cakes, however, 
made of Indian mush which has been previously well boiled, 
will agree with many. Regularity in meals is important. No 



150 DYSPEPSIA. 

food should be taken between meals. If a person of feeble di- 
gestion eat a piece of gingerbread or pie, an hour before dinner, 
the appetite will be weal^ened, and then if the patient eat the 
usual meal, the food will oppress the stomach. 

Besides the remedies already enumerated for the treatment of 
dyspepsia, there is yet one equally beneficial and suited to al- 
most every case, viz: 

A strong decoction of the powdered bayberry, with the addi- 
tion of a portion of cayenne pepper, and sweetened. This will 
remove morbid secretions, which in most instances coat the 
stomach and bowels in dyspepsia, and which must be re- 
moved before digestion can be restored. Occasionally this dose 
produces pain, and sometimes vomiting, from which the patient 
experiences benefit. No apprehension of bad consequences need 
be felt from the pain which this dose occasionally produces; it 
arises from wind or gas in the stomach, which may be relieved 
by taking No. 6, in very hot water, or by taking hot water alone; 
or essence of pepper mint: or it may be relieved by hot applica- 
tions to the abdomen. The above preparation is more especi- 
ally applicable when the tongue is coated. The No. 3 pills may 
be taken as a substitute for the bayberry tea and pepper. 

Change of Mr. — A change of residence from the city to the 
country, or from the country to the city, or removing to a dif- 
ferent neighbourhood, will in many instances restore digestion, 
when other means have all failed. I have observed the most 
remarkable change effected in dyspeptics by a few weeks' resi- 
dence in a pine country, or on the sea-bord. The benefit which 
dyspeptics receive from visiting mineral springs, arises, pro- 
bably, in the majority of cases, from the change of air, cheerful 
society, absence from care, and probably from the interruption of 
bad habits. 

Cleanliness in person and in dress, promotes digestion, and 
exhilerates the mind. An occasional vapour bath, followed by 
a shower bath, is one of the best means for promoting a healthy 
action in the skin. When the patient is languid and nervous, a 
shower bath every morning will prove a powerful tonic to the 
nervous system, and in some instances will cnre dyspepsia. The 
daily use of the flesh brush or salted towel will also invigorate 
the system, cheer the spirits, and promote digestion. 



SECTION XI. 



WORMS IN THE STOMACH AND BOWELS. 

In treating of worms, Dr. Thomson makes the following ob- 
servations. "A great deal is said about worms causing sick- 
ness, and there is scarcely a disease that children are afflicted 
with, but which is attributed to worms. The doctors talk about 
worm complaints, worm fevers, worm colics, &c., and give me- 
dicine to destroy the worms: by so doing they frequently destroy 
their patients." 

The views of Dr. Thomson concerning the cause of worms, 
to wit: that they are produced by a disordered state of the sto- 
mach and bowels, are doubtless correct. 

Different Species of Worms. — There are 

1st. The Long Thread Worm, which varies from an inch and 
a half to two inches in length. About two-thirds of its length is 
almost as thin as a horse hair, the remaining and posterior part 
being considerably thicker, terminating in a rounded or blunt 
extremity. 

2d. The Mate or Thread Worm»-—*^ This is a very small 
white worm — the male being not above two lines in length, with 
rounded or blunt extremity anteriorly, tapering to a point pos- 
teriorly. The female is considerably larger, being from four 
to five lines in length, terminating in an extremely fine extremi- 
ty posteriorly, resembling the point of the finest needle. These 
worms are found only in the large intestines, and principally in 
the lower part of the rectum, where they are often collected in 
almost countless numbers," occasioning a most annoying sen- 
sation of burning and tickling in the rectum. 

3d. The Large Round Worms. — These are a species of worms 
varying in length from three to ten or twelve inches, and about 
the size of a common sized goose quill. These worms inhabit 
the small intestines, and occasionally ascend into the stomach. 
^^ The symptoms indicating their presence are equivocal, but are 
commonly considered to be, starting in the sleep, itching of the 
nose, irregular, or excessive appetite, emaciation, 6cc. Never- 



wmmmmmmmmmmmmmmi 



152 WORMS IN THE STOMACH AND BOWELS. 

tbeless, these worms are often suspected of being present where 
they do not exist." 

4th. The Tape Worm. — The tape worm sometimes acquires a 
great length,— thirty to forty feet, and even longer. **Itis 
about half an inch in breadth, flat, white, and composed of a 
series of joints, resembling in shape, a gourd seed. It inhabits 
the upper portion of the bowels and stomach. 

The Symptoms usually accompanying the presence of worms 
in the stomacli or bowels are — paleness of the countenance, with 
occasional flushes on the cheeks; picking the nose; variable ap- 
petite, sometimes voracious — at other times entirely gone; offen- 
sive breath; copious secretion of saliva; and the tongue furred. 
The belly is swollen, and there are transient pains through the 
bowels, and starting in the sleep. These symptoms, however, 
may all exist, independently of the presence of worms, and even 
when there are worms, most of the attending symptoms may 
arise from a disordered condition of the stomach and bowels. 

^^ The reason," says Dr. Thomson, << why children are more 
troubled with what are called worm complaints, is because they 
are more subject to be disordered in their stomachs and bowels 
than grown persons. When children are sick, and their breath 
smells bad, it is said they have worms, and every thing is laid to 
them; but this is owing to disease caused by canker, for there is 
nothing in the nature of worms that can affect the breath. In 
cases of this kind, the only thing necessary is to cleanse the sto- 
mach by getting rid of the cold phlegm, and restoring the diges- 
tive powers, when there will be no difficulty with the worms." 

The practice of giving poison to kill worms in the stomach 
and bowels, as Dr. Thomson says, *' is like the story related by 
Dr. Franklin, of a man who was troubled with a weasel in his 
barn, and to get rid of the weasel he set fire to his barn and 
burnt it up." "I had the following relation," says Dr. Thom- 
som, " from the doctor who attended the cases; — three children 
had what he called a worm fever; and he undertook to kill the 
worms. One of the children died, and the doctor requested 
liberty to open it, to find out what would destroy worms, in or- 
der to know how to cure the others; but the parents would not 
consent. A second died, and the parents consented to have it 
opened; but after searching the stomach and bowels, to their 
surprise, no worms could be found. The third soon after died. 
The fact was, their death was caused by canker on tlie stomach 
and bowels, and the medicine given increased the difficulty by 
drawing the determining powers inward, which aided the cold 
to promote the canker." 



WORMS IN THE STOMACH AND BOWELS. 153 

Treatment.—' rUe difficulty of ascertaining wlietlier a child 
that is sick has worms, should occasion no embaiTiissment with 
regard to the treatment to be pursued. The stomach and bowels 
being disordered, the indications for the treatment will be the 
same whether the patient be affected with worms or not, 

*^I have had," says Dr. Thomson, **a great deal of expe- 
rience in what are called worm complaints; and after having 
become fully acquainted with the real cause, had no difficulty in 
curing all that I have undertaken." # # # # # 
" My practice," says he, *' has been what I recommend to others 
to do in cases that are called worm complaints; to give the 
composition powder, or No. 2, to warm the stomach, a tea of 
No. 3, to remove the canker, and tlie bitters, or either of the ar- 
ticles described under No. 4, to correct the bile. If they are 
bad, carry them through a course of the medicine, and give the 
bitters. When there are nervous symptoms, give the nerve 
powder. Injections should also be frequently given. The but- 
ternut syrup is very good. If tlierc should be danger of mortifi- 
cation, make use of No. 6, both in the medicine given and in the 
injections." 

The composition I have found to be most effectual wlien the 
powder is given in luke-warm water, or in a strong decoction 
of bayberry or sumac. This mixture given two or three times 
a day, together with small doses of the tincture of lobelia, re- 
peated every two or three hours, will, in many instances, remove 
a 11 symptoms supposed to be occasioned by worms. 

The compound lobelia pills given immediately after meals, 
will be found beneficial in such complaints, and they may be 
used as a substitute for the composition and tincture of lobelia. 

A mixture of vinegar and salt given three or four times a 
day, is of especial benefit in correcting a disordered stomach, 
especially when the patient craves acids. 

Milk boiled with a portion of tansy may be used to restore 
digestion; and sometimes it will cause the expulsion of worms 
from the bowels. 

Lime Water, — When the stools are green or of an acrid cha- 
racter, or if the patient be affected with sour breath, and acid 
eructations, lime water should be given to correct the secretions. 
Tfie usual way of administering lime water is to add about an 
equal quantity of boiled milk. To be taken two or three times 
a day. 

Charcoal, — Wlien the bowels are constipated a teaspoonful of 
purified charcoal may be taken two or three times a day in 
boiled milk. This will overcome costiveness, and it is high- 
ly beneficial in the cure of what are called worm complaints. 

U 



154 WORMS IN THE STOMACH AND BOAVEI.S. 

EmeticSf or a Course of Medicine should be given occa- 
sionally, as long as there is fever, or the tongue continues fur- 
red, and composition powder, capsicum, or spice bitters, to be 
administered twice or three times daily. When the fever has 
disappeared and the tongue is moist and cleaning, bitters may 
be given. When the patient continues in delicate health, after 
the above treatment, a cold shower bath in the morning, or a 
change of air, will be found particularly useful. A change of 
medicine occasionally will be proper in long-standing cases; 
thus a certain kind of bitter may be given for a few days in 
succession and then change it for another; salt and vinegar may 
agree w ith the stomach for a time, and then require to be laid 
aside for some other remedy. 

Worm Seed, or Jerusalem Oak, (Chenapodium Anthelmenti- 
cum) is much used for expelling worms. Of the efficacy of this 
article I cannot speak from observation, never having used it. 
The Volatile Oil of the w-orm seed, is generally used; the dose 
for a child is from four to ten drops mixed with sugar, and given 
in the morning on an empty stomachy and in the evening at bed 
time, w^hich may be continued several days in succession. 

Treatment for the removal of the Maw or Thread Worm, — This 
species of w^orm being located in the rectum, is usually termed 
seatworm. These may be removed by the daily administration 
of injections, composed of a strong decoction of bayberry or su- 
mac, adding a teaspoonful of No. 6. After the worms are ex- 
pelled the injections should be administered every few days, to 
prevent their return. If the general health be deranged, con- 
stitutional treatment will be required. Such as the daily use of 
stimulants and bitters, and occasionally an emetic, or a full 
course of medicine. 

These small worms are contained in a tough mucous, lining 
the bowels, and being imbedded in it will frequently resist the 
most powerful cathartics, but administering stimulating in- 
jections to excite the secretions and render them less dense and 
tenacious, and followed by the use of injections of a strong de- 
coction of bayberry or sumac, adding a portion of No. 6, will 
seldom or ever fail of evacuating the woi-ms when their use is 
persevered in. In obstinate cases of seat worms, an injection of 
a simple decoction of the bayberry or sumac should be adminis- 
tered at bed time, and retained in the bowels through the night, 
and in the morning administer another, containing a portion of 
the No. 6, or the third preparation of lobelia. 

Treatment for Expelling Tape Worms. — Every species of in- 
testinal worms, is supported by the cold mucous or "canker," 



PILES. 155 

lining the bowels. Dr. Thomson's general plan of treatment, 
namely: first to give stimulating medicine to warm the stomach 
and bowels; then use the No. 3 to remove the ^'canker," and 
bitters to restore digestion, is adapted to all cases of worm com- 
plaints. This is a plan of treatment adapted to all cases of dis- 
ease of the stomacli and bowels, whether worms be present or 
not. 

No small amount of injury has been done by experiments that 
have been practiced by physicians upon patients sujiposed to be 
affected with tape worm. A great variety of remedies and 
modes of treatment are recommended by different medical wri- 
ters; one claimiiig to have been successful, in expelling tape 
worms by a certain method of treatment; wliilst another declai-es 
that a different and even opposite course of treatment has proved 
more successful in expelling the woi'ms. Dr. Eberle gives no 
less than seven different plans of treatment recommended by 
men who have been considered eminent in the profession. Most 
of the remedies employed by the medical profession for the ex- 
pulsion of tape worms; such as tin filings, and irritating cathar- 
tics, frequently cause the formation of a false membrane on 
the mucous surface of the bowels, which will sometimes pass off 
in the form of a white skin, in pieces varying from half an inch 
to a foot, or even two or three feet in length, and this substance 
no doubt has frequently been mistaken for tape worm. Some 
writers speak of having cured many hundred cases of tape 
Avorms, but probably in forty-nine cases out of every fifty, the 
supposed tape worm was nothing more than the white skinny sub- 
stance above alluded to. 



SECTION XII. 



PILES. 



This is a disease of the veins of the rectum, which prevails 
to a great extent in both sexes, and in all classes of society. 

Piles commence by an enlargement of tiie veins in the rectum, 
forming tumours filled with dark blood, w^hich become extreme- 
ly painful on going to stool, and frequently they discharge a con- 
siderable quantity of blood; they are then called Ueedlng piles. 
When blood is riot discharged tiiey are termed blind piles. 
Sometimes the tumours emerge from the anus, forming external 



156 PILES. 

piles; Nvlien confined within the rectum they are denominated 
internal piles. 

1st. External piles, — These are at first formed within the rec- 
tum, by the blood collecting and forming into clots in the en- 
larged veins, and are afterwards forced down by the passage of 
hardened fosces, and by straining efforts to evacuate the bowels, 
attended with extreme pain, in some instances for many hours.. 
Piles are soft at first, but generally become harder in the course 
of a few^ days. 

When the disease continues for a considerable time, a portion 
of the intestine is forced down every time that foeces are passed 
from the bowels, and requires to be pressed up by the hand. In 
some instances the patient will be unable to return the protruded 
intestine, in consequence of the inflammation and extreme ten- 
derness of the parts. Under these circumstances the patient is 
compelled to remain in a recumbent position, being unable to 
walk or even to sit upright. The extreme pain which some- 
times continues for many hours after the bowels have been mo- 
ved, is caused by the piles being pushed down, and when the 
sphincter muscle of the rectum contracts, it grasps them firm- 
ly, and tlius operating as a ligature upon them, occasions in- 
tense pain. 

2d. Excrescences in the form of whitish fleshy bodies are apt 
to be formed around the verge of the anus, in consequence of 
frequently repeated inflammation of the diseased veins, by which 
their sides, as it were, are glued together, and adhesive matter is 
thrown out, which becomes organized, and a hard vascular 
swelling is produced. These excrescences are apt to occasion ir- 
ritation and chafing of the parts, and although containing nu- 
merous blood vessels, they may be cut away with a pair of sharp 
scissors, without the least hazard to the patient. 

3d. Internal Piles may exist far in tlie rectum, without occa- 
sioning pain, or much inconvenience, the discharge of blood be- 
ing tlie first symptom of tlieir existence. By the frequent pass- 
ing of hardened foeces, a relaxed condition of the bowels, or by 
the use of purgative medicine, the intestine is gradually drawn 
downwai'd, and finally is protruded beyond the anus every time 
the bowels arc moved, forming prolapsus ani. Under these cir- 
cumstances there is generally much constitutional derangement 
and more oi* less fever. 

Piles on their first appearance seldom continue for a long in- 
terval, they disappear and sometimes do not return, but more 
generally they return at intervals, until finally the parts become 



PILES. 157 

permanently diseased, proving a continued source of annoyance 
and frequently causing severe pain. 

When a number of piles exist low down in the rectum, the pas- 
sage of hard foeces is rendered extremely difficult and painful in 
consequence of the cavity of the intestine being nearly closed by 
these tumours being formed into a body near tlie orifice of the rec- 
tum. 

'* Among the most common consequences of piles is a kind of 
tenesmus, with a protrusion of the inner tunic of the rectum, so 
as to form a prominent and extremely sensitive ring around the 
anus — particularly after each attempt to expel the foeces." 

Piles are very liable to burst, followed by a discharge of blood, 
on which the tumours disappear, and the distressing symptoms 
abate until other piles are formed, which also hurst and their 
contents are discharged; and in this way some patients will 
be subjected to frequent discharges of blood, which may become 
so profuse as finally to weaken and impair the general health. 

Causes of Piles, — The free use of purgative medicines may be 
regarded as the most common cause of piles. They may, how^ 
ever, be produced by any cause that weakens the digestion, or 
occasions an obstruction to the free circulation of blood through 
the veins of the rectum; such as venereal excesses, the intempe- 
rate use of ardent spirits, sedentary habits, long continued diar- 
rhoea, dysentery, tight lacing, gravel in the bladder, lifting 
heavy weights, pregnancy, difficult labours, obstinate costive- 
ness, obstructions in the liver, and disease of the lungs. 

Treatment — In the early period of the formation of piles, the 
use of injections of some active astringent, as a strong decoction 
of bayberry bark, dewberry root, sumac, or witch hazle leaves, 
will relieve the symptoms, and may check a further develope- 
ment of this annoying complaint. 

When violent pain attends the piles, relief may be obtained 
by the patient sitting over steam, or by the application of a warm 
poultice, composed of slippery elm and lobelia moistened with 
warm water. Besides these applications, the patient should 
drink freely of composition, or bayberry tea, with the addition 
of a portion of capsicum. This will, in some degree, counter- 
act an undue determination of blood to the rectum. An emetic 
will commonly relieve the pain when the above means fail, un- 
less the disease be of long standing. Although the pain may be 
increased during the efforts to vomit, yet the circulation of the 
blood will soon become more equalized through the system, and 
the pain thereby mitigated. The excitement occasioned by the 
piles, causes an undue determination of blood to the rectum, 
which may always be counteracted to a greater or less degree 



158 PIXES. 

by the influence of a prompt emetic of lobelia, more especially 
when aided by the administration of a vapour bath. 

During the past two years I have attended many patients af- 
fected with piles, and some of them were cases of long standing, 
and have invariably succeeded either in curing them, or in 
affording signal relief to the patient by the use of injections, pre- 
pared by steeping in boiling water a compound of aspen poplar 
bark, bayberry powder, and witch hazle leaves. The decoc- 
tion should be strained, administered luke-warra, at bed time, 
and retained until morning. Patients will find no difficulty in 
retaining this injection, as it contains no stimulant to excite the 
peristaltic action of the bowels. An injection retained through 
the night will commonly cause an easy movement of the bowels 
in the morning, even in the most stubborn cases of constipation. 
The injection must be repeated every night until a cure is affect- 
ed. Besides the above treatment, I have usually prescribed the 
compound lobelia pills, a course of medicine when the system is 
much disordered, together with bitters to restore digestion. 

Dr. Thomson, in his Guide to Health, mentions the case of 
an '^ elderly man, in South Reading, who had been confined to 
his bed for seven weeks with the piles, and seven doctors had 
attended him before I was sent for, and he had continued to grow 
worse. The doctors had operated on one side, and said they 
must on the other; it was their opinion, as well as his, that he 
was in a decline. The side they had operated upon was much 
worse to cure than the other. I carried him through a regular 
course of the medicine twice in three days, when he was able to 
go out of doors. The injections were composed of No. 3, steep- 
ed, and a small quantity of No. 2 was used; warm tallow was 
applied several times a day; and occasionally the parts were 
washed with the above tea. He had been dieted very low; I re- 
stored his digestive powers, his appetite returned, the sores heal- 
ed, and his general health amended to such a degree, that he was 
no more confined with that complaint." 

Injections prepared and used as directed in a former para- 
grapli, retained through the night, have in some instances en- 
tirely checked the discharge of blood from piles, where the bleed- 
ing had previously returned at frequent intervals for a period of 
several years, the wan appearance of the patients showing how 
much they suffered from the excessive loss of blood. I have al- 
ways found it necessary in such cases, to give stimulants and 
bitters, and sometimes a course oi medicine. 

External piles that remain soft may be lessened, and some- 
times dispersed, by washing frequently with a tincture of bay- 
berry, or by applying some ointments containing astringent 
properties ; — for instance, witch hazle, or sumac leaves, or 
rhattany root stewed in tallow or mutton suet, adding a small 



PilES. 159 

portion of beeswax to render it more adhesive. If external piles 
should continue until they become hard, they may be punctured 
by the point of a lancet, and the clot of blood must be squeezed 
out, and the parts washed with tincture of bayberry, and then 
ointment or tallow applied. It is easy to distinguish between 
piles, and those fleshy excrescences which sometimes form about 
the margin of the anus: piles have a dark livid appearance, 
whilst fleshy excrescences have a light colour, and feel spongy. 

Excrescences. — These are small bodies of a fleshy appearance, 
sometimes varying from half an inch to an inch and a half in 
length, and being well supplied with blood vessels and nerves, 
they sometimes become a source of great annoyance. 

** The mode in which these excrescences are produced is as 
follows: — The inflammation of the piles glues the sides of the 
veins together; adhesive matter is thrown out, which becomes 
organized, and a hard swelling, in which there is a number of 
vessels, is produced. The excrescences project from the surface 
a little way up the anus, which is chafed and rendered extremely 
irritable from this cause. These excrescences are easily re- 
moved by a pair of sharp scissors, or applying a ligature very 
tightly, so as to obstruct the circulation: the latter method is 
much more painful than excision. 

When a portion of the intestine protrudes every time the 
bowels are moved, the injections previously spoken of will prove 
the most effectual means of curing the disorder. 

Diet — This is of the first importance in severe cases of piles 
attended with obstinate constipation of the bowels. When the 
passage through the bowels is greatly obstructed by piles, and 
the parts are highly sensitive and painful, the diet must consist 
of such articles of food as are most likely to prevent costiveness, 
such as gruel made of unbolted wheat flour, or bread made of 
the same material, rye mush and molasses, or cream, Indian 
mush and cream, stewed prunes, in small quantities, eaten with 
stale bread or biscuit. Ripe fruits, calves' foot jelly, &c. 



CHAPTER IV. 



SECTION I. 



RHEUMATISM. 

The origin of this form of disease may be traced to constitu- 
tional disorder, and loss of vital power. 

Cold and dampness are the exciting causes of rheumatism in 
almost every instance. Where, however, there is a strong pre- 
disposition to the disease existing, inaccuracies in diet, over ex- 
ertion, loss of rest, or any other depressing influence may occa- 
sion the disease. I never knew a case of rheumatism that was 
not preceded or accompanied by a greater or less degree of de- 
rangement in the digestive power. Patients, however, will 
sometimes insist that nothing is wrong about the stomach or 
bowels. The low degree of sensibility in the stomach and bow- 
els induces patients to consider that no derangement exists in 
these organs, when at the same time, their functions may be so 
far depressed and deranged, as to give rise to the most painful 
affections in other parts of the system, as gout, rheumatism, 
headachy neuralgia, erysipelas, &c. 

Parts Jffeded, — Rheumatism generally attacks the larger 
joints, the hip, shoulder, elbow, or knee, and frequently the 
small joints become affected, more especially those of the fingers 
and toes. The head, heart and brain are also liable to this form 
of disease. 

Varieties.—When rheumatism attacks the young and athletic, 
the disease is usually accompanied with inflammation of the dis- 
eased parts, attended with swelling, extreme tenderness, and 
frequently a redness of the skin, and generally there is more or 
less fever, especially at night. Such a case would be termed 
acute or inflammatory rheumatism. When the disease occurs in 
the aged and infirm, and especially in those of broken down 
constitutions, the powers of nature are too feeble to establish an 
efficient curative action; the affected parts will remain pale, and 
seldom much swollen; the disease will be fixed in certain joints 



RHETJMITISM. 161 

and not shifting about; there will be absence of fever and thirst, 
and the affected joints much less tender than in the former va- 
riety. This is called chronic rlieumatism. The symptoms, 
however, in different cases, present great diversity of character, 
from the most acute and inflammatory to that of the lowest grade 
of chronic rheumatism; so that in some instances it will be diffi- 
cult to decide whether to call the disease acute or chronic. 

Mercury sometimes occasions disease of the joints resembling 
rheumatism, and it also affects the membrane that covers the 
bone, and is most apt to be seated on the long and flat bones — 
the tibia or shin bone, the arm bones, shoulder blade, skull, &c. 
Sometimes it commences with a protuberance rising on the bone, 
without inflammation or pain, and either remaining stationary, 
or gradually disappearing under proper treatment, or, as is 
more commonly the case, the part becomes extremely painful, 
and is frequently followed by suppuration. This disease is not 
always confined to the covering of the bone, but occasionally the 
substance of the bone itself is diseased, occasioning its decay, 
attended with a discharge of acrid and offensive matter. 

Symptoms of the Acute or Iiiflammatonj Variety. — The disease 
generally approaches in a gradual manner, with a sense of cold- 
ness or numbness in the limbs, loss of appetite, weakness and 
langour. These symptoms continue for several days, or even 
weeks, in some instances, before reaction takes place, and the 
parts become either swollen, painful, or inflamed. Pain, tender- 
ness, with a slight degree of swelling and redness of the joints, 
characterize inflammatory rheumatism. " The patient generally 
lies on his back, and avoids every motion of the body or limbs; 
or if he does move, he experiences a sudden aggravation of pain; 
he cries out, and muscular motion is promptly checked. There 
is little langour or debility, and but little disturbance of the 
mental faculties." The tongue is thickly coated, and there is 
usually perspiration on tlie face, and frequently on the whole 
body, which is acid, and exhales a peculiar odour. The urine 
is acid, and deposits a sediment, especially as the disease declines. 
The pain and distress is more aggravated at night, frequently 
attended with fever, and sometimes slight delirium ; or as it is 
usually expressed, the patient is ^* light headed.'^ In some in- 
stances all the limbs are affected at the onset, the patient being 
almost helpless. In other cases the disease is confined first to the 
lower extremities, and then sooner or later it extends to the shoul- 
ders, neck, elbows, and hands. If the patient fall to sleep he is 
apt to be awakened by a sudden jerk or contraction of the mus- 
cles, causing severe pain. 

The functions of the liver are in many instances conspicuous- 
ly disordered in rheumatism, attended with sallowness of the 

V 



162 RHEUMATISM. 

skin, whites of the eyes, and occasional sickness and vomiting 
of bile. After a spell of vomiting, the patient experiences tem- 
porary abatement of the rheumatic pains. Although bile he 
thrown off by vomiting, it does not prove that there is an unu- 
sual quantity formed; digestion being suspended or greatly im- 
paired, the usual quantity of bile is not used in the process of 
digestion. 

JVot dangero2is, — Rheumatism rarely proves fatal, except when 
seated in the brain, or translated to the heart, or other important 
internal organs. 

Duration of the Disease. — The length of time required for the 
cure of rheumatism, varies in different cases, from a few days to 
several weeks, and even months. Inflammatory rheumatism is 
universally admitted to be more easily cured than chronic. In- 
flammation is the curative process by which nature overcomes 
the disease, and w^hen the inflammatory action subsides without 
affecting a crisis, or the vital powers are prostrated by blood- 
letting, purging, or the use of nitre, antimony, &c., the disease 
Is fixed in the system, and receives the name of chronic rheuma- 
tism. <*Some practitioners," says Dr. Willan, "continue to 
let blood in most cases of acute rheumatism, thinking themselves 
justified in their mode of practice by the sizy appearance of the 
blood. The same principle might lead them to empty the whole 
sanguiferous system; for every time blood-letting is repeated, 
the blood becomes more dense or sizy. I have further observed 
that, by bleeding repeatedly, the pains, swellings, and febrile 
symptoms, were not only aggravated at the time, but often pro- 
tracted infinitely; at least, I have seen them continue, under 
such a mode of practice, upwards of two months." 

Treatment of Rheumatism, — It is admitted by the opponents of 
Thomsonism, that the Thomsonian practice is suited to the cure 
of rheumatism. Experience has fully tested the insufficiency of 
the regular practice in the cure of rheumatism; and that in many 
instances, where this practice has failed, the disease has been 
cured by the aid of warm weather alone. 

The Constitutional Treatment is to be conducted upon general 
principles, with this great point always in view, namely: to aid 
nature in her efforts to restore the diseased parts to a healthy 
condition. Vitality being weakened, the treatment must be 
adapted to cleansing the stomach and bowels; to ** ripen and 
remove the canker;" to support the <^ internal heat," and to re- 
store digestion. 

In general capsicum is the best stimulant* It may be taken 



HHEUMATISM. 163 

in tea or in pills, or in combination with composition, or bayberr j. 
Pills composed of equal quantities of capsicum and lobelia, are 
especially beneficial. 

Lobelia. — -Besides pure stimulants, broken doses of lobelia 
should be given, sufficient to excite slight nausea, in order to 
produce some degree of relaxation. The above pills answer a 
good purpose, two or three of which may be given every hour or 
two. The lobelia may be given in various forms, in pills, 
tea, powder, tincture, or in the third preparation. Lobelia and 
pepper are particularly indicated in the first stage of the dis- 
ease. 

A Course of Medicine^ early administered, before the disease 
becomes seated, will in some instances effect a crisis, provided 
the patient be kept warm in bed, and use be made of stimulants 
to continue perspiration. Upon the degree of integrity of 
the general health retained, depends in a great measure the ra- 
pidity of the cure. Thus, if the digestive powers be greatly 
prostrated, or if there be chronic disease of the liver, the treat- 
ment will require to be continued for weeks, in many instances, 
before the rheumatism can be cured. The parts affected in 
rheumatism possess a low degree of vitality, and when they be- 
come diseased, so as to occasion inflammation, it is usually very 
slow in its progress to a favourable termination. 

When the patient can be got out of bed without causing great 
pain, and can bear to sit up, the full course of medicine should 
be given, either daily or at intervals of several days, as the case 
may seem to require. 

When, however, the disease has become seated, and the pa- 
tient cannot be moved without great pain, and more especially 
during the early period of tlie disease, emetics may be given 
without the bath, for in some instances it is better for the patient 
to be kept at rest, with a moderate and regular heat around him, 
than to have the inflamed parts aggravated by getting out of 
bed, and by frequently changing the clothing. When the skin is 
dry and hot, external dry heat may cause the patient more dis- 
tress, and an increase of pain. The chamber is sometimes too 
cold to admit of the exposure of the patient's body to the air, and 
under such circumstances the steaming may be dispensed with. 

The Vapour Bath — There is a period in rheumatism, or a cer- 
tain condition of the system, when the vapour bath will prove 
most signally beneficial; under other conditions of the system it 
is apparently of but little benefit, the relief afforded being only 
momentary. As a general rule" it is the most effectual, either 
before the disease becomes firmly seated, or whilst it is forming a 



164 [RHEUMATISM. 

crisis, or after it lias reached its height, and also on its decline. 
In most cases, however, it is heneHcial in all stages of the dis- 
ease, provided the patient can be moved without great pain. 

The patient should be showered after steaming, or washed with 
spirits or vinegar, rubbed dry, and the surface bathed with stim- 
ulating liniment, No. 6, or pepper sauce. 

Emetics aid very much in bringing the disease to a crisis. I 
have found a prompt emetic, either with or without a previous 
steaming, to afford more relief than any other remedial means. 
I attended a young man a few months after his arrival in this 
country, from England, who was taken down with rheumatism. 
He soon became almost entirely helpless, with great pain, and 
redness, and swelling in his joints. The tongue was heavily 
coated, and the skin pale and relaxed, with an occasional flush 
on one or both cheeks; generally with perspiration on the face and 
body emitting a sour smell. I gave this patient a teaspoonful 
of the liquid of the third preparation of lobelia, in a teacup half 
full of hayberry or No. 3 tea, about every two hours, and con- 
tinued the use of it for two weeks, when the tongue began to clean, 
and the soreness to abate. He was then steamed every day, and 
recovered rapidly. Sometimes the medicine would produce no 
sickness, except once or twice a day, when vomiting would come 
on, by which he always obtained relief. I do not say that this 
patient might not have been cured sooner by thorough courses of 
medicine, but the season of the year, and the situation of the 
room, prevented it. I have not mentioned tliis case as an extra- 
ordinary one, but merely to point out a course of treatment that 
may be pursued where the regular course cannot be given. In 
many cases I have found the compound lobelia pills effectual, 
given in doses of from three to four every two or three hours. 

In the early stage of rheumatism, it is important to relax the 
system, if the inflammotory action be very high, or the patient 
feverish; not however to break down the curative action, but to 
i^emove a part of the difficulty against which nature is strug- 
gling. 

Injections may be used as the state of the bowels seem to re- 
quire. When the rheumatism is principally seated in the lower 
extremities, injections of the third preparation, or of some form 
of lobelia, in the No. 3 tea, are especially indicated. The circu- 
lation in the lower extremities is to a greater or less degree in- 
fluenced by stimulating injections. 

The parts affected by rheumatism possess a low^ degree of sen- 
sibility, and when they become so much diseased as to excite 
reaction and occasion inflammation, it frequently requires several 
weeks before the parts are restored to a healtliy condition, even 



BHEUMATISM. 165 

under the most judicious and persevering course of treatment. 
The condition of the stomach, howels, and liver, influences in a 
great degree both the violence and duration of the rheumatism. 

Case. — Mr. J , whose health had been feeble for two or 

three years, attended with sallowness of the skin, was attacked 
with rheumatism, so as to be helpless. I was applied to, and 
administered two courses of medicine with marked benefit at the 
time, but he soon relapsed. I gave it as my opinion to the pa- 
tient, who was a man possessing high intellectual attainments, 
that there was a false membrane coating his stomach and bow- 
els throughout, which must be removed by a persevering 
course of treatment before the rheumatism could be cured. Dis- 
couraged at not finding more permanent relief from the opera- 
tions he had undergone, he determined on making a trial of the 
regular practice. Colchicum, and a great variety of other reme- 
dies were used both internally and externally, but with no good 
result, but on the contrary, with a manifest exhaustion of 
strength. I received a message requesting me to call on Mr. 

J again. I found him evidently worse than when I left 

him. He said he had become convinced that what I had previ- 
ously told him in regard to the false membrane was correct, and 
desired that a thorough course of treatment should be pursued 
until the stomach and bowels should be cleared of this false mem- 
brane. Accordingly, a thorough course of treatment was pur- 
sued, and in about two weeks the false membrane began to be dis- 
charged, sometimes passing from the bowels in pieces a foot long. 
At the end of three weeks the patient was cured, and has ever 
since enjoyed better health than during several previous years. 

Where a joint is distorted by rheumatism — for instance, the 
foot turned in, or the wrist bent, drawing the hand down, or 
sidewise — the case is generally very slow to recover. 

When rheumatism becomes deeply seated, requiring a long 
course of treatment, it will be advisable occasionally to change 
the medicines, or at least to alter the form, or to combine them va- 
riously. Besides the remedies already noticed, may he men- 
tioned, gum guaiacum, balsam copaiva, oil of juniper, and white 
mustard seed. Simple herb teas are frequently found beneficial 
in promoting perspiration. 

The gum guaiacum is to be pulverized and taken in molasses. 
The dose an even teaspoonful two or three times a day. The 
halsam copaiva may be taken in doses of from fifteen to twenty 
drops, first rubbed up with a teaspoonful of slippery elm and 
sugar, with the addition of a little water. This should be 
repeated three or four times a day. The oil of juniper is to be 
prepared and taken in the same way. 



166 RHEUMATISM, 

The dose of the white mustard seed is a tablespoonful two or 
three times a day. 

I have known rheumatic patients to be benefitted by eating 
raw onions, more especially in chronic cases. 

The compound lobelia pills are well adapted to all cases of 
rheumatism; and on account of the facility with which they may 
be taken, they will generally be preferred to decoctions. In 
many instances I have succeeded in curing rheumatism by a free 
use of the above pills, together with an occasional course of me- 
dicine. After a course of medicine, diluent drinks should be 
given v/ith a view to continue a moderate perspiration. A weak 
infusion of bonesett, chamomile, or elder blossoms, or a tea of 
composition, spice bitters, ginger, or capsicum, may be used as 
the nature of the case may require, or the fancy of the patient 
dictate. 

Tonics should be used when the disease is on the decline, and 
the patient clear of fever. More particularly are tonics indicated 
wiien the system is in a weak and relaxed condition. Where 
the case requires the continued use o( tonics, they may be changed 
occasionally with advantage. Various kinds of tonics may be 
used, such as aspen poplar, peruvian bark, guiac shavings, 
columbo, balmony, quassia, golden seal; or garden bitters, as 
wormwood and tansy. They may be prepared in decoction or 
in tincture. Thomson's No. 6 is also a good tonic. 

The Diet in rheumatism, as in every other disease, should be 
adapted to the condition of the digestive powers. In the acute 
or inflammatory form of the disease, digestion is in general 
either suspended or much enfeebled, requiring the lightest kinds 
of food, such as crust coffee, barley water, elm gruel, toast and 
tea, milk porridge, &c. When a patient is suffering acute pain, 
the digestion is imperfect; and when the stomach is oppressed 
with food that it cannot digest, the rheumatic pains will be ne- 
cessarily aggravated. 

In a more advanced period of the disease, or when it becomes 
chronic, a stronger diet may be required, such as soft boiled, or 
poached eggs, stale bread and butter, moderate quantities of 
fresh beef, roasted or broiled, mutton, wild game, together with 
wholesome vegetables. In some cases animal food agrees with 
the stomach, and in others an almost exclusive vegetable diet 
will be most proper. 

Local ^Applications, — There is probably no form of disease in 
which so many different local applications have been recom- 
mended as in this. In some instances local applications are ser- 



RHEUMATISM. 167 

viceable, and in otliers they prove entirely useless. And again, 
an application that agrees with one case, will increase the pain 
in another; and the same application that may ease pain in one 
stage of the disease, may prove entirely useless, or even injuri- 
ous at another period. Thus, raw cotton, bound on an inflamed 
joint may excite perspiration and relieve pain in one, and in an- 
other it will increase it. Many will find relief from warm poul- 
tices, whilst in others the pain will be aggravated by them.. In 
general, warm poultices and volatile liniments are beneficial. 
Thomson's No. 6, with a portion of camphor, or four parts of 
No 6 to one of spirits of turpentine, will be particularly useful 
in many cases. Two ounces of olive oil, mixed w4th half an 
ounce of ^^ water of ammonia," form a volatile liniment, appli- 
cable in the acute or inflammatory stage of rheumatism. The 
stimulating liniment frequently alluded to in this work, prepared 
by my brother A. Comfort, is one of the best external applica- 
tions for rheumatism that I have ever made use of, and generally 
answers in both the acute and chronic forms of the disease. 
After rubbing the parts well with the liniment, they should be 
bound up with flannel or silk oil cloth. 

The following poultice is highly recommended by some who 
have used it. 

Take of slippery elm, four ounces. 
Wheat bran, do. 
Capsicum, one ounce, 
Brown lobelia, do. 
Fine salt, two tablespoonsful, 
Soft soap, half a pint. 

Mix these together, and sufiicient warm water to make into a 
proper consistence for a poultice, and apply it. The poultice 
must be wet occasionally to prevent it from becoming dry and 
hard. Dr. Shaw informs me that he used this poultice with the 
most marked success, in a case of chronic rheumatism. After 
applying the poultice some time, ulcers were formed on the sur- 
face over the diseased parts, but which healed under the repeated 
application of the same poultice, and the joints were rapidly re- 
stored to a more healthy condition. 

In some instances the pain and inflammation will fix upon a 
part for a day or two and then suddenly change to another place, 
and in this way will fly from one limb to another; and a part 
that will be extremely painful, red and swollen, and tender to 
pressure, may, in the course of a few hours, be entirely free 
from inflammation or pain. I attended a gentleman recent- 
ly aflected with acute rheumatism, where warm applications, 
except steaming, increased the pain, and where almost instant 



16S 



RHEUMATISM. 



relief was found by applying a cold poultice, made of grated 
raw potatoes: the disease in this case was confined principally 
to the feet, not affecting the larger joints. 

In deep seated cases of long standing, sea bathing, cold shower 
baths, or travelling over a mountainous country will sometimes 
affect a cure. 

When rheumatism attacks the brain or heart, or other internal 
organs, the treatment must be thorough in the commencement, 
for if the disease become firmly seated, particularly on the 
brain, it will sometimes terminate fatally, although the most 
vigorous measures may have been perseveringly employed. 
Rheumatism very rarely, however, becomes translated to inter- 
nal organs under the use of Thomsonian remedies, but it is not 
an uncommon occurrence under a depleting course of treatment. 
Almost every writer on medicine furnishes testimony to the dan- 
ger of copious bleeding in rheumatism, from the liability of the 
disease being thereby translated to the heart and other internal 
organs. 

During the past winter I attended a young man with a severe 
attack of pericarditis^ or rheumatism of the heart. The patient 
was seldom able to lie down except after a vapour bath and an 
emetic, but would sit all night in a bent posture, experiencing 
severe pain from efforts to cough, or to take a deep breath; the 
pulse was irregular and extremely feeble; there was great op- 
pression of breathing, and the voice low and very feeble; the 
pain was seated in the region of the heart, the limbs were all 
affected with rheumatism and Jiis feet very much swollen. In 
this case I found no other means so effectual as a course of me- 
dicine. The bowels were obstinately constipated, and seldom 
moved by injections. This patient recovered in the course of a 
few weeks, under a general stimulating treatment, together with 
an occasional vapour bath and an emetic. As in all cases that 
I have attended of seated disease, a false membrane was passed 
off from the bowels, and flakes of it were frequently thrown up 
by vomiting. 



SECTION II. 



LUMBAGO— RHEUMATISM IN THE LOINS. 

This form of rheumatism is to be treated upon the same ge- 
neral plan as that recommended for rheumatism, namely: by 
courses of medicine; pure stimulants; astringent, or " canker 
medicine;" and finally by tonics. 

Twenty or thirty drops of the spirits of turpentine, three or 
four times a day, is an effectual remedy in many cases of lum- 
bago. The use of the turpentine, and an occasional vapour 
bath, together witli a strengthening plaster to the back, may 
succeed in curing light cases. The stomach and bowels, how- 
ever, are in most instances disordered, and require a course of 
medicine, and the use of stimulants, such as capsicum and com- 
position, prickly-ash. No. 6, &c. 

Fricklij-ash. — This medicine in decoction, taken freely, is 
decidedly useful in chronic rheumatism wherever it is located. 
The prickly-ash, finely pulverized, may be added to the spice 
bitters in the proportion of one part of the former to four parts 
of the latter. 



SECTION III. 



GOUT. 

Gout is a constitutional disease, being always connected with 
a disordered state of the digestive organs. The disease usually 
comes on by fits or paroxysms, and the attacks in most instances 
occur at night. The pain is generally seated in the ball of the 
great toe, though it is liable to attack other parts of the limbs, 
and also internal organs, namely: the stomach and kidneys. 

Its hereditary tendencij — Some families are peculiarly predis- 
posed to gout, almost every member of a family being more or 
less affected by it in advanced life, when the digestive powers 
usually fail. This hereditary tendency to gout may be trans- 
mitted from parents to children, through several generations. 

W 



170 GOtJT. 

The same debilitating cause that would produce gout in one 
predisposed to the disease, might occasion pleurisy, erysipelas, 
or some otiier form of disease in another. 

JSTot confined to the luxurious and md'o^e?iL— Gout though prin- 
cipally occurring in those who have ^^ feasted and drank abun- 
dantly" still it does occasionally attack individuals who have 
lived temperately, and have led an active life. In every case of 
the kind, however, that I have had a knowledge of, the patient 
was dyspeptic, and had a sallow complexion, indicating a torpid 
state of the liver. 

Causes,— 'W\\Qn there is a predisposition to gout, an attack 
may be brought on by almost any debilitating cause, such as 
exposure to cold or dampness, over exertion, or taking more food 
into the stomach than can be digested, thus causing debility of the 
general system. Tbe disease is most apt to occur in persons of 
a peculiar confirmation of body, with alimentiveness large, and 
who are habituated to eating largely of the richest kinds of food, 
together with the free use of wine and brandy. At length the 
digestive powers become enfeebled. The habit of eating heartily 
having become established, more food is taken than the stomach 
can digest; the imperfectly digested food form acids, the gene- 
ral system becomes disordered, and gout follows. 

When this disease attacks individuals who lead an active life 
and are temperate in their habits, it is owing to constitutional 
disorder; the general health being more or less impaired previ- 
ously to the gouty attack. 

The Ordinary Symptoms of Constitutional Disorder which gen- 
erally precede an attack of Gouty are, uneasiness and distress at 
the pit of the stomach; frequent belching of wind; sour eructa- 
tions; furred tongue; a sense of tightness and weight in the ab- 
domen; ** giddiness; great lassitude; yawning, and stretching 
of the limbs; cramps in the muscles of the legs; drowsiness, with 
disturbed sleep, depressed spirits, and debility. In some in- 
stances a disagreeable itching of the skin comes on a few days 
previous to the attack, and in most cases the urine has a deep 
red colour.'' Coldness of the extremities, with a sensation of 
numbness is very often experienced before an attack of gout. 

Characteristic Symptoms. — lu most instances an attack of gout 
commences at night. It is attended by severe pain, tenderness, 
and throbbing in the ball of the great toe; chilliness or ri- 
gors, soon followed by reaction; the skin becomes hot and dry, 
and the pain violent and throbbing, as though there was a con- 
tinued succession of electric shocks passing through the tender 



GOUT. 171 

part. At the approach of daylight, the pain ahates, and a pro- 
fuse perspiration ensues. "In some instances tlie pain and 
fever continue with unabated violence, until about the middle of 
the following niglit, when they decline under a moderate flow of 
sweat — the patient sinking into a quiet sleep towards morning. 
In very severe attacks, however, no obvious remission of t!ie 
symptoms takes place, until the third or fourth morning. Yet 
in all instances, the sufferings of the patient are greater during 
the fore-part of the niglit than in the day. When the affected 
part is examined in the morning, after the accession of the pa- 
roxysm, it is found swollen, red, and the veins of the foot greatly 
distended with blood. ^' The tenderness is so great, that the 
least pressure or motion in the part, occasions excruciating pain. 
The temper during the paroxysm, is irritable, the patient being 
difficult to please. 

The duration of the first attack of gout, varies from four or 
five to eight or nine days; *'but in subsequent attacks, it is often 
protracted beyond the second, or to the end of the third week. 
After the disease has subsided in one foot, it sometimes attacks 
the other, and passes regularly through its course as in the first 
instance. 

After an attack of gout the general health of the patient is 
usually much better than it was for some time previous to the 
attack. The disease however returns at longer or shorter inter- 
vals, in some instances only once in a few years — in others every 
year, and after the constitutional energies become greatly enfee- 
bled, the patient will seldom be entirely clear of it, except during 
mid-summer. 

Chronic Gout. — From great exhaustion of constitutional ener- 
gy, gout is apt to assume the chronic form, and instead of occur- 
ring in paroxysms at different periods, the parts become perma- 
nently affected, not with acute inflammation, but by '^chronic 
wandering, and irregular pains, bearing much resemblance to 
chronic rheumatism." 

*^ The pain in chronic gout is usually moderate during the 
day, the patient experiencing only a sense of alternate heat and 
coldness in the affected parts; at night, however, it is generally 
severe and aching. A feeling of numbness and weight is expe- 
rienced in the diseased parts, and slight cramps are apt to occur 
during the fore part of the night, and the sleep is restless, and 
interrupted by sudden startings. The affected joints retain their 
natural, or present only a slight purplish hue; but they become 
oedematous, tender, and more or less stiff, and the neighbouring 
muscles are weakened or diminished in size. The inflammation 
often passes successively from one joint to another, or leaves 
its original seat, and fixes upon some distant joint, and aftej? 



172 GOUT. 

having remained there for a while, returns to the part it had 
left." 

'* There is rarely any very conspicuous fever, hut the diges- 
tive and biliary organs are generally very permanently derang- 
ed. The dyspepsia attending this form of the disease is partic- 
ularly characterized by great oppression, and flatulent disten- 
tion of the stomach after a full meal, together with heartburn, 
and occasionally a sense of coldness in the stomach. The bow- 
els are usually torpid or affected with mucous diarrhoea; the 
urine is turbid, and often charged with mucous; the skin dry, 
contracted, and sallow; the bilious secretion deficient; and both 
the animal and vital functions much impaired. The temper in 
this variety of the disease is always very irritable, dissatisfied, 
morose, irresolute, and sometimes gloomy or hypochrondical. 
In some instances, pain is occasionally felt in the kidneys, or 
neck of the bladder, and generally matter is discharged with the 
urine. 

Gout is not exclusively confined to external parts, but is liable 
to attack the stomach and other internal organs, and also the 
brain. Cold applications to the diseased extremities, copious 
bleeding, continued active purging, or any other debilitating in- 
fluence may occasion gout to be translated to internal parts. 
** When an acute attack of gout passes to the brain, coma, furi- 
ous delirium, or symptoms of apoplexy, speedily ensue." When 
it fixes upon the stomach, violent cramps or spasms of this organ 
ensue, which in many instances terminate fatally, or reaction 
hecoraes established exhibiting symptoms of inflammation in the 
stomach. 

Treatment — A paroxysm of gout will require the same gene- 
ral plan of treatment as any other violent attack of disease. A 
course of medicine will relieve the violence of the symptoms and 
assist in bringing about a crisis. 

In the premonitary stage before the reaction or pain comes 
on, a course of medicine will lighten the severity of the pain, and 
shorten the paroxysm. 

Treatment during the parojcysm, — An attack of gout should 
he treated in the same manner as a case of bilious colic, or in- 
flammatory rheumatism; applying the remedies as the urgency 
of the symptoms may require. The bowels to be relieved by 
the use of enemas; the system warmed by the vapour bath, and 
the stomaeh cleansed by emetics. During the paroxysm, the 
vapour bath may be administered frequently, provided the pa- 
tient finds relief from it. 

Emetics. — Free vomiting will sometimes relieve the pain after 



GOTJT. 17 



« 



all other usual means have failed. After vomiting, the patient 
should take capsicum tea freely, or a teaspoonful of the third 
preparation of lobelia, in a tea cup half full of composition or 
bayberry tea, frequently repeated. In very severe cases I have 
found it necessary to repeat the above named doses at intervals 
of fifteen or twenty minutes, and continue them for hours in suc- 
cession. 

Injections, — Much benefit may be derived from an occasional 
enema, made actively stimulating with the third preparation of 
lobelia; when there is much fever it will be proper to adminis- 
ter an injection of lobelia powder in luke-warm water, to be re- 
tained, and repeated until the system becomes more or less re- 
laxed under their influence. In some, this treatment will cause 
a great degree of relaxation, in others, the bowels may be almost 
insensible to the impression of the lobelia, and scarcely any visi- 
ble effects be produced. 

When the disease attacks the stomach, or other internal or- 
gans, the treatment will require to be prompt and vigorous, de- 
pending chiefly upon the third preparation of lobelia, or a like 
preparation administered in frequent and full doses. Medicine, 
however, will in some cases fail of having the desired effect 
without the aid of the vapour bath, or the application of warm 
bricks, wrapt in damp cloths, placed around the patient. As 
superabundance of acid in the stomach will sometimes prevent 
or greatly retard the operation of the emetic, the use of salsera- 
tus, or bi-carbonate of soda, will then be required. 

Local Remedies, — In general, stimulating and volatile liniments 
afford more or less relief. The parts should be wrapped in 
flannel or cotton, provided the pain be not increased thereby. 

Intermediate Treatment* — After a paroxysm of gout, the treat* 
ment should be directed to effect a restoration of the general 
health, and thus to overcome the liability to another attack. — 
This may in many instances be accomplished by an occasional 
course of medicine, together with pure stimulants, the "anti- 
canker medicine," and at a proper time the use of powerful to- 
nics. The continued use of the compound lobelia pills at night, 
will have a good effect on the bowels. In some cases wiiere 
individuals are subject to attacks of gout, the habit of eating too 
freely of rich food has become so fixed with them that the sto- 
mach contiimes to be oppressed with more food than can be di- 
gested, and thus the patient is subjected to continued returns of 
gout. 

In the chronic form of gout, besides an occasional course of 
medicine, the use of strong infusions of vegetable bitters, will 



174 INFLAMMATION OE THE KIDNEYS. 

often prove beneficial. Gum guiacum, spirits of turpentine, 
and savine, (juniperus sabina) may also be found useful in the 
chronic form of the disease. 



CHAPTER V. 



SECTION I. 



INFLAMMATION OF THE KIDNEYS. 

The kidneys may become diseased from various causes, such 
as exposure to cold and dampness, intemperance, blows, contu- 
sions and strains, the use of cantharides and other irritating di- 
uretics, translated rheumatism or gout, and the formation of 
gravel in the kidneys. Where there is constitutional weak- 
ness in tlie kidneys, they may become diseased and take on in- 
flammation by almost any debilitating influence, but more espe- 
cially from cold and damp feet. 

Symptoms— Arisiu^ from disorder of the general system, or 
from exposure to cold, constitutional derangement, such as chil- 
liness and languor, loss of appetite, torpid bowels, flushes of heat, 
and fever, precede inflammatory action in the kidneys. When 
this takes place there is tenderness to pressure, and pain in the 
region of the kidneys, which is greatly aggravated by a sudden 
jar, from making a false step, or by suddenly bending the 
body forward. The pain is apt to shoot down towards the 
bladder and thighs. *^With these symptoms are usually con- 
joined fever, nausea and sickness, retching and vomiting, colicky 
pains and constipation. The urine assumes a variety of appear- 
ances, — it is high coloured, ropy, depositing sediment, foetid, or 
bloody. 

Terminations, — Inflammation of the kidneys, under proper 
treatment, generally terminates in a restoration of the parts to 
a healthy condition. 

The Favo2irahle Signs are a subsiding of the pain; a general 
warm perspiration; a copious discharge of urine, generally 



INFLAMMATION OE THE KIDNEYS. 1T5 

either turbid or charged with mucous; clearing of the tongue; 
and subsidence of the sickness and vomiting. 

Where acute inflammation of the kidneys does not terminate in. 
resolution (the restoration of its natural action) by the seventh or 
eighth day, suppuration very commonly ensues, and an abscess 
is formed. 

The symptoms denoting the formation of an abscess, are 
shiverings and fever, occurring at irregular intervals, resem- 
bling ordinary ague or hectic fever; a pulsating pain in the kid- 
ney; a feeling of heaviness or numbness in the affected part; and 
great irritation of the bladder and urethra. Abscess of tiie kid- 
ney may ** point externally, and be discharged, or it may open 
into the abdomen, and occasion severe and fatal peritonitis." In 
other instances the matter passes down the ureters into the blad- 
der, and is discharged with the urine. In some instances an ab- 
scess will continue to discharge in this way for many months, 
and even years. 

Treatment. — To moderate the violence of tlie pain, and at the 
same time to aid the efforts of nature in bringing about a favour- 
able termination of the disease, Thomson's course of medicine, 
in the author's opinion, is decidedly the most beneficial. 

The Course of Medicine should be given early in the attack, 
and repeated daily if the symptoms demand it. There will be 
little inconvenience in vomiting, as straining efforts will sel- 
dom increase the pain to any great degree when the system is 
relaxed by the lobelia and vapour bath. 

Injections, — The kidneys may be greatly influenced by medi- 
cines administered by injection. To move the bowels, they should 
be made stimulating, and contain a portion of lobelia. When 
the skin is hot and dry, the secretions of the mouth suspended, 
and the pain in the kidney severe, broken doses of lobelia should 
be given by the mouth, and administered by injection with the 
view of producing continued nausea, and the patient should take 
freely of pennyroyal or other simple herb teas, and an occasional 
dose of pepper or composition. 

The Vapour Bath, — From the close sympathy existing between 
the skin and the kidneys, the vapour bath will prove highly ben- 
eficial, and may be administered frequently. Where the patient 
cannot bear the fatigue of sitting up, the steam should be applied 
to the patient on a couch or mattress. Not only is the vapour 
bath useful by exciting perspiration, but it attracts the blood to 
the surface, and thus lessens the undue determination to the dis- 



176 iNFIiAMMATIOJf 01- THE KIDNEYS. 

eased part. The same effect is produced by the emetic. The 
vapour bath is more especially indicated where the secretion of 
urine is nearly, or wholly suspended. For where the functions 
of the kidneys are suspended, those of the skin should be promo- 
ted, otherwise the urea will remain in the blood and occasion 
serious consequences. In some instances, however, the patient 
requires to be kept in a state of perfect rest, and other means 
should be used for promoting perspiration. 

External Remedies,- — Besides the vapour bath, warm bricks 
wrapped in cloths dampened with vinegar and water, should be 
placed under the bed-clothes, and as near the patient as can con- 
veniently be borne, and warm poultices applied to the small of 
the back, and kept warm, either by placing a hot brick against 
them, or as they become cooled, they should be taken off and re- 
applied as hot as can be borne. 

Biet. — This should at first consist of such articles as crust 
coffee, elm gruel, barley water, &c., and continued in until the 
inflammation subsides, and a favourable crisis take place. 

When an abscess forms, the general health must be sustained 
by a proper use of pure stimulants, '' anti-canker medicine," 
and mild tonics, spice bitters, or a tea of poplar bark. 

The Symptoms of Calculi, or Gravel in the Kidney s, independ- 
ently of inflammation are, excruciating pain in the region of the 
kidneys down to the bladder; constant sickness at the stomach, 
with frequent retching and vomiting; pain in the inside of the 
thigh; retraction and pain in the testes, and stranguary. 

The gravel may pass off and give perfect relief, or the pa- 
roxysms may continue, and inflammation ensue. 

I visited a patient who had symptoms of gravel in the kidneys, 
under the care of Dr. Fonerden. The patient had taken two 
or three courses of medicine, and at the time I saw" him, the sys- 
tem was very much relaxed under the influence of lobelia, and 
he had what are termed the alarming symptoms; and the family 
of the patient being unacquainted with the effects of the medi- 
cine, were much alarmed. During this relaxation, the patient 
in voiding urine, passed a calculous or gravel stone, about three 
quarters of an inch in length, as thick as a common goose quill, 
and was immediately relieved. 

Gravel in the kidneys arises from a disordered condition of 
the digestive organs, and is generally associated with full living, 
particularly in persons predisposed to gout. 

When the calculi are first formed in the kidneys, they are 
generally of acid deposites. The urine will be high coloured 



INITLAMMATIO?? OF THE KIDNEYS. 177 

and will change litmus paper to red. and deposites a sediment of 
red, yellow, or pink colour on standing. Tliis acid character of 
the urine attends childhood and persons ahout the age of forty. 

As the constitutional energies hecome more enfeebled, the cha- 
racter of the gravel is apt to change from that of an acid to an 
alkaline deposite; the urine becomes pale, and deposites a white 
sediment or crust on standing. 

Treatment of Gravel in the Kidneys, — To relieve the pain, and 
facilitate the expulsion of the gravel, and at the same time to 
lessen the tendency to severe inflammation, a regular course of 
medicine will prove most effectual. 

Besides the course of medicine, injections of the lobelia pow- 
der should he given occasionally wdth a view to relax the system, 
and lessen the determination of blood to the kidneys A tea- 
spoonful or two of the third preparation of lobelia, in a teacup 
half full of bayberry tea, should be given every hour or two, 
when the pain is severe. Wliether the disease be gravel or in- 
flammation in the kidneys, lumbago, gout, or rlieumatism, the 
treatment here recommended will be proper in each case. 

Mkalies should be used in combination with the other medi- 
cines, when the urine is acid, — salseratus or the bi-carbonate of 
soda; the former is to be preferred. Alkalies must be occasion- 
ally used, as long as the urine indicates the existence of acid. 

Jdds* — When the urine is pale, and deposites a white crust, 
or sediment, acids should be used, as vinegar, or the pepper 
sauce, especially at meals. Lemon juice may be used in drinks, 
or a beverage may be made of other kinds of acid fruit. 

Predisposition to tlie formation of gravel is to be overcome by 
restoring the general health by the use of pure stimulants, ''anti- 
canker medicine" and tonics, besides the use of alkalies or acids, 
as the case may require. An occasional course of medicine will 
be very useful to restore the general health. 

Change of Air. — In deeply seated complaints, benefit is derived 
in many cases, from a change of residence, wiiere medicine fails 
of effecting any permanently good result. A few weeks' resi- 
dence at the sea shore, or in a pine country, or among moun- 
tains; at the mineral springs, Schuyley's mountain, Saratoga 
springs, and other like places of fashionable resort, has in many 
instances renovated the general health, and removed the ten- 
dency to gravel, where medical treatment has failed. 

X 



■SECTION II. 



INFLAMMATION OF THE BLADDER. 

This is a disease of rare occurrence, except in a chronic fornij, 
the bladder not being liable, generally, to acute inflammation. 

Causes.— AcutQ inflammation of the bladder is sometimes oc- 
casioned by repelled gonorrhoea. It has also been produced by 
the use of cantharides, (Spanish flies,) and by the excessive use 
of turpentine. The disease is accompanied by a disordered state 
of the digestive functions. Inflammation of the bladder may 
also be brought on by injuries inflicted by blows, retention of 
urine, or by the use of forceps in labour, or by the injudicious in- 
troduction of the catheter. When the bladder is predisposed to 
disease, exposure of the feet to cold and dampness may occasion 
inflammation,— still the disease is of rare occurrence. 

The Symptoms are,— an almost constarst desire to pass urine; 
burning pains in the region of the bladder, which frequently 
shoot through the testes, and down the thighs; and extreme 
tenderness in the region of the bladder. The patient is seldom 
able to pass much urine, and that which is voided is of a deep 
red colour, and frequently tinged with blood. There is much 
distress at the stomach, with sickness and vomiting. The 
bowels are costive, and if the inflammation extend to the rectum 
there will generally be more or less dysenteric symptoms. 

More or less reaction attends acute inflammation of the 
bladder. The skin is dry and hot, the pulse quick, the tongue 
coated and dry, with excessive thirst; the patient is extremely 
restless, and the countenance is expressive of great anxiety. 
When the neck of the bladder is inflamed, there will be retention 
of urine, and any attempts to introduce the catheter or bougie 
causes extreme suffering. 

Terminations. — ^Inflammation of the bladder terminates either 
in resolution, suppuration, gangrene, or a thickening of the 
coats of the bladder. 

Favourable Sig7is. — When the inflammation is about to ter- 
minate in resolution, which signifies a restoration of the parts to 
their natural condition, there will be general perspiration, with 



IXFLAMMATIO^T Or THE BXADDER. 179 

an uniformly warm skin; subsidence of the pain; the parts less 
tender to pressure; and a free discliarge of urine, with but little 
pain. 

Suppitration Inflammation of the bladder very rarely termi- 
nates by suppuration. When this does occur, the pain and fever 
are lessened; the patient experiences chills or rigours, and a 
white matter is discharged with the urine. 

Gangrene occurs much more frequently than suppuration. 
When gangrene is about to take place, the pain and fever sud- 
denly cease; there is great prostration of strength; ^^cold ex- 
tremities; profuse and clammy perspiration;" pulse weak and 
frequent; hiccough; confusion of mind; and a death-like expres- 
sion of countenance. 

Sudden and severe attacks of acute inflammation of the blad- 
der usually run their course to a favourable or to a fatal termina- 
tion, by the seventh or ninth day. In some instances the dis- 
ease becomes seated, or as it is expressed in medical language, 
the inflammation assumes the chronic form. 

Treatment — Severe attacks of inflammation of the bladder, 
require energetic treatment in the early period, and a perse- 
vering course to be continued until the disease abate, or the case 
prove hopeless of cure. As in all severe attacks of disease, re- 
peated courses of medicine must be chiefly relied upon, or tlie 
system kept under the influence of lobelia, which will aid in 
equalizing the nervous influence, and will promote perspiration. 

Injections to the bowels must be used freely in order not only 
to remove their contents, but also to influence the action of the 
bladder. Tlie lobelia powder, administered by injection, and 
retained, will tend to relax the neck of the bladder, and favour 
the escape of urine; and besides this, it fulfils other important 
indications, equalizing nervous influence, and promoting the va- 
rious secretions. Occasionally lobelia administered in this way 
will produce sickness and vomiting, and greatly relievo the pain 
in the bladder. 

The Vapour Bath is useful in inflammation of any internal or- 
gan or tissue. It attracts the blood to the surface, and power- 
fully assists to equalize its circulation; it relieves pain; aids the 
efforts of nature to overcome obstructions; and renders the sys- 
tem more susceptible to the impressions of medicine. The bath 
is to be repeated as the circumstances of the case may require; 
and if the patient find relief by the bath, it may be administered 
very frequently. If, however, the patient be more easy when 



180 INFIAMMATIOX OF THE BLADDEK. 

kept quietly in bed, with warm poultices applied to tiie parts, 
the bath may be disused for the time. Most physicians of the 
old school use the vapour bath in this disease. 

Poultices composed of indian mush and flaxseed, stewed an 
hour or more, then adding ginger and green lobelia, or compo- 
sition powder, must be constantly applied to the abdomen. A 
poultice prepared by stewing wormwood and tansy in vinegar, 
and thickened with indian meal or slippery elm, may be 
used. 

Diet — During the active stage of the disease, the stomach will 
not digest any food except it be of the most bland and mild cha- 
racter, — e\m gruel, flaxseed tea, adding a small portion of loaf 
sugar, — barley water, and crust coffee. 

If the tongue be thickly coated, the patient should take occa- 
sionally a strong decoction made of sumac leaves and berries, 
adding a portion of cayenne, or of the third preparation of lobe- 
lia. This preparation is also well adapted to those cases where 
suppuration occurs in the bladder, or the inflammation assumes 
the chronic form. 

Chronic Injlammation of the Mucous Membrane of the Bladder 
is a common form of disease. 

Symptoms.' — '^ Slight lancinating pains, attended with a sense 
of burning in the region of the bladder, and a feeling of weight 
and tenderness in the perinseum; frequent and harassing desire 
to pass urine, with occasional spasmodic action of the bladder 
and urethra. The urine is loaded more or less with a tenacious 
mucus. Slow fever generally attends, accompanied with thirst; 
general debility, particularly about the back and loins; and in 
protracted cases, much emaciation and exhaustion supervene. 
There is generally considerable derangement of the digestive 
functions; loss of appetite; sometimes nausea and vomiting; cos- 
tivencss; tongue covered with a white or brown fur; and the 
skin is harsh and dry.*' 

Chronic inflammation of the bladder is often associated with 
gout, and scrofula. It prevails most in the aged and infirm, 
and more especially in the intemperate. 

Treatment — Chronic inflammation of the bladder is to be 
cured by a course of treatment best adapted to restore the 
general health, together with stimulating injections to the 
bowels, composed of a strong decoction of sumac leaves or ber- 
ries, adding a portion of cayenne and lobelia; and a free use of 
an infusion or tea, of either pipsissewa, sumac bark, leaves, or 



INFLAMMATIO:ff OE THE BLADDER. 181 

berries; uva ursi, or bear berry; or buchu. An infusion of peach 
tree leaves is highly spoken of by some practitioners. Balsam 
copaiva has been used with much benefit in this disease. 

Jin occasional Course of Medicine, and the patient kept in a 
perspiration for several hours after, will in general prove the 
most effectual metliod for the cure of chronic as well as acute in- 
flammation of the bladder. 

When the patient is infirm and far advanced in life, it will 
generally be useless to attempt to effect a cure, more especially 
if the disease be of long standing. The treatment in sucli cases 
should be of a palliative character. 

The same symptoms tliat accompany chronic inflammation of 
the bladder attend, also, disease of the prostrate gland, stone 
in the bladder, stricture of the urethra, and ulceration of the 
neck of the bladder. The constitutional treatment, however, 
will require to be the same in each case under similar conditions 
of tlie general health. Thus, if the stomach be disordered, an 
emetic will be proper whether the patient is affected with stone, 
or with simple inflammation of the bladder. If there be reten- 
tion of urine from spasm of the neck of the bladder, or from stric- 
ture of the urethra, the vapour or warm bath, and injections to 
the bowels, to relax the parts, will be equally applicable in either 
case. 

A German applied to me affected with retention of urine, and 
the introduction of a catheter twice a day had been required for 
the three preceding weeks. A full course of medicine was given, 
and he did not need the use of the catheter after. Even where re- 
tention of urine is occasioned by stone in the hladder, a full course 
of medicine may overcome the difficulty in many instances, al- 
though permanent relief is not reasonably to be expected by it. 
Where there is a stone in the bladder that is very hard, it can 
be removed only by an operation. 



SECTION III. 



DIABETES— EXCESSIVE FLOW OF URINE. 

The more prominent Symptoms, of this form of disease, are— 
a profuse discharge of urine; excessive thirst; voracious appe 
tite; clean tongue; dry skin; and wasting of the flesh. 

Character of the Urine — Various derangements in the system 
may exist, accompanied by an increased flow of urine, but essen 
tially different from diabetes. Diabetic urine contains sugar, 
giving it a sweet taste and smell; " and if dropped and partly 
dried upon linen or paper, it is glutinous and adheres to the fin 
fiers. The amount of urine discharged varies in different cases, 
but it is always very great; and in some instances seven or eighi 
quarts have been discharged in the course of twenty -four hours, 
and this continued for several weeks in succession. 

CauseSo — A depraved state of the digestive functions, and ar 
exhausted state of the vital powers, are the essential causes ol 
this complaint. 

The disease prevails commonly in old age, and in constitu- 
tions broken down by intemperance or debauchery. It some- 
times prevails in children after protracted cholera infantum. 

The disease difficult of cure. — Occurring as a consequence ol 
a worn-out or broken-down state of the system, genuine diabetes 
is very rarely cured. Recoveries from it, however, do happen 
under a judicious and persevering course of treatment. 

Where the disease is not overcome, the strength and flesh con- 
tinue to waste, hectic fever occurs, and frequently consumption 
of the lungs, dropsy, and apoplexy supervene. 

Instances have occurred in which several members of the same 
family died of diabetes, thus showing, as it would seem, a here- 
ditary tendency to the disease. 

The disease, in some instances, arrives at its course in a few 
weeks, whilst in others it will continue for many months, or even 
years. 

Treatment The important indications are to restore the di- 
gestive and nutritive functions. To accomplish this, the prin- 
cipal dependence must be upon courses of medicine in the early 
stage of the disease. There are no means so effectual in revo- 



DIABETES. 183 

iiitionizing the system, and in breaking the chain of disorder- 
ed action as courses of medicine. Yet in diabetes, unless ad- 
ministered in the very onset of the disease, and under favoura- 
ble circumstances in relation to the constitutional vigour of the 
system, even these will be found unavailing. If the constitution 
be broken down, or the patient advanced in life, it would not be 
advisable to subject the patient to any unpleasant operation by 
medical treatment, for under the circumstances first mentioned 
there cannot be a reasonable hope entertained of effecting a cure. 
It must be borne in mind, however, that the system is liable to 
disorders attended with a profuse discharge of urine, differing 
essentially from diabetes. 

Repeating the Course of Medicine. — In the early stage of the 
disease the course of medicine may be frequently repeated, pro- 
vided the patient should experience benefit by the operation. 
When the condition of the stomach does not require the emetic, 
the bath may be applied daily, with a view to relax the skin, and 
cause a determination to tiie surface. The vapour bath may 
also have an influence in changing in some degree, at least for a 
time, the thickened state of the blood, which in diabetes is ob- 
served to be thick like molasses, probably owing to a loss of its 
natural temperature, and a weakened state of circulation. The 
caloric and electricity imparted by the vapour bath, exert 
a most decided influence in vitalizing the blood, by facili- 
tating its circulation through the lungs, and by restoring its 
natural temperature. When the patient is too feeble to bear sit- 
ting up, the vapour bath may be applied in bed, and in this way 
a moderate perspiration continued by it for an hour or two. 
When the skin is very dry and harsh, it may be difficult to ex- 
cite perspiration, and the patient will consequently be more or 
less oppressed with heat, and require frequent sponging over the 
face and body with tepid water, or vinegar and water until per- 
spiration be brought on. Capsicum tea or other stimulants should 
be given, together with nauseating doses of the tincture of lo- 
belia. 

The sumac leaves and berries made into a strong decoction, 
adding a small portion of cayenne, will be proper to be occasion- 
ally given; and during the first period of tlie disease, frequent 
doses of tlie tincture of lobelia, or the compound lobelia pills, 
should be administered. 

Tonics will be proper, more especially where the symptoms 
assume a more favourable aspect. The thoroughwort or bone- 
sett may be used as a tonic in any period of the disease, and 
where this treatment requires to be long continued, an occasional 
change or alternation of the tonics may be appropriate. 



184 HETEJfTION OE URIKE. 

The No. 3 pills may be used as a substitute for the sumac tea, 
if the patient prefer this convenient form. 

Stimulating liniments, pepper sauce, or No. 6, should be ap- 
plied to the surface of the body and limbs, after a vapour bath, 
and friction to the skin daily persevered in. 

Diet. — The food must consist of the most nourishing kind that 
the stomach will bear. Eggs, beef, mutton, milk, &c., ansv^er 
well in many cases. Meat, in the early period of the disease, 
however, and more especially if there be fever, will be improper. 

Vegetahles, in most instances, disagree with the stomach, and 
in some cases, even a small piece of bread will do injury. 

Animal Food is recommended in diabetis. In some instances, 
however, it will not suit the stomach, — when custards, arrow^ root, 
eggs, milk porridge, rice and milk, 6cc. may be substituted. 

From the feeble state of the digestive powers, and the vora- 
ciousness of the appetite, there is an extreme liability to eat more 
than is proper. 

The clothing should be very warm, and especial attention is 
necessary to keep the feet dry and warm. 

Exercise in the open air is beneficial where the patient is able 
to get out, either to walk or to ride. 

Diabetes^ however, is very seldom cured, when it occurs in 
depraved, or otherwise broken down constitutions: these com- 
monly form an insuperable barrier to the success of the practi- 
tioner, though a ray of hope may be still held out, as in the 
most desperate cases cures are sometimes effected. 



SECTION IV. 



RETENTION OF URINE. 



The urine may be retained in the bladder either from inflam- 
mation or constriction in the neck of the bladder; mechanical 
obstructions in the neck of the bladder or urethra; or from a 
loss of the power to contract the bladder, and expel its contents. 

1st. Iiiflammation in the JYeck of the Bladder is one of the most 
common causes of obstruction to the passage of urine. The in- 
flammation may arise from a diversity of causes, such as the ap- 



RETENTIOX OF rUlNE. 185 

plication of fly blisters to any part of the body or limbs; the in- 
ternal use of turpentine, or cantharidcs; disease of the prostrate 
gland, or of other parts in close sympathy with the bladder; ex- 
posure to cold and dampness; an acrid state of the urine; re- 
pelled gonorrhoea; and constitutional disorder, more especially 
in gouty patients. 

2d. Mechanical Ob stmctions,— These are gravel in the neck of 
the bladder, or urethra; stricture of the urethra; enlargement 
of the middle lobe of the prostrate gland; prolapsus uteri; and 
pressure of the uterus upon the neck of the bladder during preg- 
nancy. 

Sd. Paralysis, or a loss of power to contract the Bladder, occurs 
from injury of the brain and spinal marrow; palsy of the lower 
half of the body; malignant disease, as typhus fever; blows or 
falls upon the back; over-distension of the bladder from reten- 
tion of urine caused by mechanical or other obstructions; inju- 
ries sustained during child-birth; from exhaustion of nervous 
power from bad habits or from old age. 

Treatment. — Whether the retention of urine be occasioned by 
inflammation, or spasm in the neck of the bladder, or urethra, 
or from mechanical obstruction, the constitutional treatment 
proper in the one case, will be equally applicable in the other. 
Mechanical obstructions, however, in many instances, require 
other means besides constitutional treatment. 

In ordinary cases, retention of urine may be relieved by evac- 
uating the bowels by injections containing a portion of lobelia, 
together with the use of means for equalizing the circulation, 
and producing perspiration, by hot stimulating teas, and the 
vapour or warm bath, or a blanket wrung out of hot water, 
folded several times, and laid over the abdomen, or by applying 
a bag of hops, wet with hot vinegar. 

Injections. — One of the most effectual remedies for stoppage of 
urine, is the use of injections of lobelia powder, in luke-warm 
water, and caused to be retained in the bowels. This, together 
with the application of warmth to the surface, as above mentioned, 
w^ill seldom fail of removing the difficulty, unless the retention 
should arise from gravel in the urethra, or neck of the bladder, 
or from other mechanical obstructions. Even when there is a 
mechanical obstruction, the above means should be used, with a 
view to relax the parts, which will not only afford relief, but 
render the removal of the mechanical obstruction less difficult. 

The Vapour Bath fulfils several important indications in the 
stoppage of urine. It seldom fails of affording more or less re- 

Y 



186 RETENTION OF URINE. 

lief from pain, and, in some instances, will be sufficient, when 
well applied, to remove the obstruction, more especially when it 
is occasioned by inflammation, or spasmodic contraction in the 
neck of the bladder, brought on by exposure to cold and wet 
Medical men most generally resort to tobacco injections, ir 
severe cases, for the purpose of producing relaxation. This, 
however, sometimes produces serious consequences, from the poi- 
son of the tobacco being absorbed into the blood. The lobelia 
will answer every good purpose that could be desired from the 
tobacco, and without any risk to the patient of bad consequences 
from its employment, even in large quantities. In aggravate(] 
cases it may be found necessary to use powerfully stimulatins 
injections to the bowels, with a view to prevent stagnation o 
the blood, in the diseased parts. For this purpose, the liquid o 
the third preparation of lobelia will be proper, and may be usee 
in larger or smaller quantities, as the case requires. 

Emetics,— In some instances retention of urine is associate( 
with extensive derangement of tbe stomach, so that emetics ma] 
be found not only advantageous, but necessary; and when the ob 
struction is not overcome by the means above stated, it will b( 
proper to give an active emetic of the third preparation of lobe 
lia, or some like preparation, such as the brown lobelia, givei 
in bayberry tea, adding a teaspoonful of capsicum to each dose 
The vapour bath previous to the emetic will render the latte] 
more effectual. 

Retention of urine is always more or less dangerous when con 
tinned over twenty-four hours without any urine passing. It ii 
therefore highly important to persevere in the treatment until tht 
obstruction be partially or wholly removed. Thus in some casei 
it may be found necessary to keep the patient fully relaxed, foi 
many hours together, under the influence of the lobelia injections 
and also to repeat the emetics every two or three hours, togethei 
with the frequent application of the vapour or warm bath, or f 
constant moist heat kept around the patient. The drink shoult 
consist chiefly of elm gruel, flaxseed tea, watermelon-seed tea, 
barley water, &c. 

Introduction of the Catheter. — When the catheter can be intro- 
duced it gives instant relief, but when the urethra or neck of th( 
bladder is highly inflamed, it will be worse than useless!to at 
tempt to pass a catheter. When the system is fully relaxed, th< 
catheter may in some instances, be introduced by one acquaintee 
with the proper manner of using it. Much harm, however 
often arises by repeated attempts to pass the catheter when there 
is much inflammation. It is in paralysis of the bladder that th( 
use of the catheter sometimes becomes indispensable. But ir 



RETENTION or URINE. 187 

those cases attended with a burning pain in the neck of the blad- 
der, with tenderness to pressure, and a continued and painful 
desire to pass urine, the catheter cannot be introduced safely 
even by the most skilful surgeon, and every attempt made to in- 
troduce it, only tends to increase the difhculty. 

Tappi7ig the Bladder, — When gravel is lodged in the neck 
of the bladder, or in the urethra, and in cases of stricture, 
every effort to overcome the obstruction may sometimes prove 
abortive Under these circumstances, the last and only re- 
source is in tapping the bladder, as the only means of saving 
the patient's life. This operation, of course, will demand a sur- 
geon, and one who is fully acquainted with the anatomy of the 
parts. 

In retention of urine from falling of the womb, or from its re- 
troversion, the introduction of a bougee may be sometimes ne- 
cessary. 

Treatment of Retention of Urine from Faralysis of the Bladder, 
— The chief dependence here must be in the use of the catheter, 
stimulating injections to the bowels, together with the employ- 
ment of such remedies as tend to give tone to the bladder, either 
by general constitutional treatment, when the circumstances of 
the case require it, or by the use of stimulating diuretics, such 
as the oil of juniper, balsam of fir, or Peruvian balsam. 

In low forms of fever, the bladder, in some instances, looses 
the power to contract and expel the urine, and becomes greatly 
distended, which, if not relieved, may occasion serious conse- 
quences. This should be borne in mind by those who have the 
charge of patients very ill of typhus, or other malignant forms of 
fever; ancl when there is evidence of a great accumulation of 
urine, as will be manifested by a hard tumour in the right side 
of the belly, means should be used for evacuating it; and when 
hot fomentations to the abdomen, and stimulating injections to 
the bowels fail of producing a discharge of urine, it should be 
drawn off by the introduction of a catheter; or at least an attempt 
should be made to accomplish it. 

In severe injuries of the back, paralysis of the bladder frequent-^ 
ly occurs, and requires the repeated use of the catheter until the 
power of contraction is restored to the bladder. 

When it depends upon the debility consequent upon old age, 
then fresh air, vapour baths, friction to the surface, stimulating 
diuretics, and if the patient can bear it, occasionally a shower bath 
in the morning must be employed. The urine should be drawn 
off before the bladder becomes greatly distended, for if this be 
permitted to occur, it tends still further to weaken the bladder. 
In some instances, to prevent distention of the bladder, the use of 



188 STEANGIJART. 

catheter will be required three or four times in the course of twen- 
ty-four hours, in order to afford an opportunity to the bladder to 
regain power to contract and expel its contents. 

Onions mashed fine, and applied to the perineum, are said to 
have had a good effect in many instances, in^restoring the tone 
of the bladder. 



SECTION V. 



STRANGUARY. 



(Diri-ICrLTY AND PAIN IN VOIDING IJIIINE.) 

When the urine is voided with great difficulty, and in small 
quantities, attended with severe burning pain, and a continued 
desire to urinate, it is called strangiiary. The difference, there- 
fore, between stranguary, and retention of urine is, that in the 
former, the urine passes, though it may be by mere drops, and 
attended with a painful desire to void it; whereas in the latter 
there is a complete obstruction to the passage of urine. 

Causes. — Stranguary is in almost every instance associated 
with constitutional disease. It is liable to occur at any period 
of life, sometimes attending the period of teething in children, 
and it is very common in old age. The application of a fly blister 
to any part of the body, will occasion stranguary in some; and 
the same effects are sometimes produced by the internal use of 
turpentine. 

Gout, gravel, and piles, are often attended with difficulty and 
pain in voiding urine. The intemperate use of spirituous li- 
quors; venereal excesses; exposure to cold and dampness, or 
whatever else tends to derange the general health, may occasion 
stranguary in persons predisposed to it. ** Nervous and hyste- 
rical females are liable to extremely violent pains in the neck 
of the bladder and urethra, and which are generally most intense- 
ly felt immediately after discharging urine." Stranguary in 
the old and feeble, is sometimes occasioned by an enlargement of 
the prostrate gland, but more commonly it arises from other 
causes, as disease of the coats of the bladder, irritating acids in 
the urine, and gravel. 



STRANGTJAIIY. 189 

Treatment — Infants may be relieved of strangiiary by the 
warm hip bath, or fomentations to the belly, together with the 
use of injections to the bowels, composed of half a teaspoonful 
of the tincture of lobelia, or the same quantity of green lobelia 
in composition tea. If the general health be much deranged, an 
emetic may be employed, followed by the use of flaxseed, or wa- 
termelon-seed tea, and occasionally by small doses of the tineture 
of lobelia. 

When stranguary is occasioned by a Mister, this of course 
should be removed, and the patient take mucilaginous drinks, as 
elm, flaxseed tea, &c. If this does not remove the diificulty, re- 
course should be had to fomentations and injections. When it 
arises from the use of turpentine, the same constitutional treat- 
ment above recommended, will be proper. 

Associated with gout, tlie chief dependence must be on consti- 
tutional treatment, with a view to correct the acrid state of the 
urine, and to restore the general health. As a means of afford- 
ing relief during severe attacks, the w^arm bath, vapour bath, 
or hot fomentations should be used, together with injections con- 
taining a portion of lobelia. 

When it arises from gravel constitutional treatment will be also 
proper, for which an occasional course of medicine will prove the 
most effectual. When the urine is high colored, and deposites 
a reddisii or yellow sediment on standing, alkalies should .be 
used, such as salseratus, bi-carbonate of soda, or a tea of hickory 
ashes 

When stranguary is occasioned by irritation from piles, a 
strong decoction made by steeping witch hazle, or sumac leaves 
in boiling water, should be administered by injection, and re- 
tained in the bowels for several liours, which will lessen irrita- 
tion in the piles, and in this way the occurrence of stranguary 
may be prevented. The lobelia injections and hot fomentations 
may be found necessary to relieve the immediate symptoms of 
painful irritation. 

Wiien accompanied with hysterical symptoms, an emetic or a 
full course of medicine will be necessary. The same constitutional 
treatment that will cure hysteria, will also remove stranguary. 
When the stranguary arises from prolapsus, or other displace- 
ment of the womb, the same constitutional treatment will be 
proper, more especially the enemas containing lobelia; the 
vapour bath, and hot fomentations. It sometimes happens, how- 
ever, in displacement of the uterus, and more especially in its 
retroversion, that the introduction of a gum elastic bougee into 
the bladder to draw off the urine, becomes necessary before the 
displacement of the uterus can be overcome. 

Females aff*ected with fluor albus, or whites, are subject to se- 
vere burning pain on voiding urine, in consequence of an ex- 



190 INCONTINENCE OF URINE. 

tremely irritable state of the urethra. Injections of a strong 
decoction, prepared by steeping witch hazle or sumac leaves in 
boiling water, adding a small portion of capsicum, should be 
used two or three times a day, with a female syringe, beside 
resorting to the usual means for restoring the general health, 
by which the parts will become strengthened. 

When attendant upon old age, or occurring in constitutions 
exhausted by debauchery and intemperance, a permanent cure 
of stranguary is not to be anticipated : a relief of the symptoms 
will be all that can in general be effected by any course of treat- 
ment whatever. 



SECTION VI. 



INCONTINENCE OF URINE. 



(involuntary flow of urine.) 

Incontinence of Urine, though not in general attended with 
pain, is nevertheless, in many instances, a very troublesome com- 
plaint. It prevails most during childhood, and in old age. 

Inability to retain the urine, with children, is commonly ow- 
ing to constitutional weakness in the urinary organs. Some- 
times it arises from an acrid state af the urine; and occasionally 
it is caused by gravel. Weakness of the urinary organs may be 
induced by frequently having wet and cold feet. 

The aged and feeble are especially liable to incontinence of 
urine, from weakness or paralysis of the sphincter muscle of the 
bladder, by which the urine is retained at the command of the 
will. In some instances the action of this muscle is completely 
lost, and the urine is continually passing off by drops as fast as 
it enters the bladder from the kidneys. This complaint is fre- 
quently associated with palsy and gout. Involuntary dis- 
charges of urine often take place in protracted fevers, where 
patients are extremely low, and observation proves it to be an 
unfavourable symptom. In fine, the same causes that produce 
retention of urine in one, may occasion stranguary in another, 
and in another an inability to retain the urine. Thus gravel, or 
stone in the bladder, which frequently occasions a stoppage of 
urine, in other instances will cause the urine to pass off involun- 
tarily. 



INCONTINENCE or URINE. 191 

Treatment — Incontinence of urine in children, is in most in- 
stances removed by the natural increase of constitutional strength. 
When the general health is impaired, constitutional treatment 
will be required, such as, an emetic to cleanse the stomach, and 
if the stools exhibit an unhealthy appearance, injections may be 
used to advantage, not only in correcting the bowels, but also 
to add strength to the urinary organs. The injections are to be 
prepared in the ordinary form. A strong tea made of the sumac 
bark, leaves, or berries, or of the aspen poplar bark, will be 
beneficial in strengthening the urinary organs, either in the 
young or old. For an adult, a teacup two-thirds full, and for a 
child, a wineglassful of the tea may be taken two or three times 
a day. If the urine be high coloured, and deposites a sediment 
on standing, alkalies must be used, such as bi-carbonate of soda, 
salseratus, a tea of hickory ashes, or lime water. 

A cold shovf'er bath in the morning; friction to the surface 
with a salted towel, nourishing diet, exercise in the open air, and 
whatever else tends to invigorate the system, will also strengthen 
the urinary organs. 

Children often evacuate tlie urine involuntarily at night dur- 
ing sleep; and in some instances this habit continues even to 
adult age. Voluntary discharge of urine frequently takes place 
under the influence of a dream. *' Incontinence of urine," says 
Mr. Charles Bell, *' never takes place but when the boy is 
asleep upon his back; and the cure is a very simple one. He is 
to accustom himself to sleep upon his face or side; the urine is 
not passed, nor is he excited to dream of making urine, while he 
keeps this posture. The circumstance is unaccountable, until 
we reflect upon this master-spring oi the neck of the bladder — 
the sensible spot, a little behind and below the orifice of the blad- 
der. When a person lies upon his belly, the urine gravitates to- 
w^ards the fundes; but when he lies upon his back, it presses 
upon this sensible spot, and distends that part of the bladder 
which is towards the rectum." 

Long continued inability to retain the urine, more espe- 
cially when associated with old age, is in general an incurable 
complaint. 



SECTION- Vtii 



SUPPRESSION OF URINE. 



(the KIDIS^EYS CEASING TO EORM TJHINE.) 

Bu'p'pression is to be distinguished from retention of urine, as 
in the former the kidneys ceasee to select the urine from the blood, 
consequently none is formed; whereas in retention the urine is 
formed, but the passage by which it escapes from the bladder 
is obstructed. The chief danger attending retention of urine is 
over distention of the bladder; but when the urine is not formed 
in consequence of a loss of action in the kidneys, the suppression 
is of serious consequence if long continued. 

The loss of action in the kidneys is a consequence of great de- 
rangement in the system, and seldom occurs except in the last 
stage of disease, when the living powers are fast sinking and the 
patient beyond the reach of recovery. Suppression of urine, 
however, does occasionally take place under circumstances dif- 
ferent from tliose above mentioned, that is: it sometimes oc- 
curs when the living powers are not so far exliausted but that 
the patient may recover under energetic treatment. 

Symiitoms.—^hQ suppression may be either partial or com- 
plete, and the only certain metliod of determining the suppres- 
sion is by introducing a catheter into the bladder. 

Suppression of urine cannot continue long without producing 
serious consequences. " There is fever, thirst, a taste similar 
to that of urine in the mouth, and a smell of urine in the perspi- 
ration; to these nausea, vomiting, sometimes of fluids, having 
an urinous odour, and hiccup succeed; and to these oppressed 
breathing, delirium, and eventually stupor and convulsions. 

Treatment — Suppression of urine calls for prompt and ener- 
getic treatment, with a view to excite action in the kidneys. 
When the suppression takes place with a group of other symp- 
toms, denoting a fatal termination, as in the last stage of a dis- 
ease, all remedial measures must of necessity prove useless. — 
When there is a probability of a recovery being effected, stimu- 
lating injections should be administered to the bowels, and a 



SUPPRESSIOX or URINE. 



193 



tablespoonful of the third j)rcparation of lobelia may be used in 
each injection, and repeated frequently. 

Steaming is of the greatest importance, not only to throw 
the urea out of the blood by perspiration, but it sustains and aug- 
ments its vitality by the heat and electricity imparted to it, and 
by quickening its circulation through the lungs. 

Emetics will also aid in restoring action in the kidneys. 

Hot stimulating poultices must be applied to the urinary re- 
gion, or small of the back, and kept warm. 

The patient should be kept in a perspiration, — ^this is very im- 
portant. 

The treatment above directed will be applicable not only to 
the suppression of urine, but also to the removal of the constitu- 
tional disorder which may have caused the loss of action in the 
kidneys. It must not be inferred that I would recommend a 
thorough course of treatment in those cases where the patient is 
evidently in the last stage of disease, and past the hope of re- 
covery. 

Case.— I attended a gentleman near Germantown, who had 
been confined to his room nearly the whole of the winter, and he 
having, as he supposed, suppression of urine, desired me to at« 
tend him. No urine had passed during seventy-four hours, and 
this was unaccompanied by any distention in the region of the 
bladder. He complained of pain and heaviness in the head, 
showing that the disease was assuming a serious aspect. A tho- 
rough course of medicine was administered, and stimulating in- 
jections repeated frequently, together with the free use of stimu- 
lating medicine. Not long after this treatment had been com- 
menced, the kidneys resumed their functions, and the patient re- 
covered rapidly: the enemas used for restoring action in the 
kidneys, had the effect also of removing the original disease, 
which had occasioned the suppression. 



2- 



CHAPTER Yt 



SECTION li 



DISEASE OF THM LIVElL 



ACUTE INFLAMMATION OF THE LIVER. 

Acute inflammation of the liver does not occur frequently in 
temperate climates. 

Causes, — Inflammation of the liver may be induced by blows 
or otlier injuries in the region of the liver; a sudden check to 
perspiration after violent fatiguing exercise; by gall stones, 
which are hardened concretions formed in the gall bladder, and 
found in the ducts; or it may be occasioned by the same in- 
fluence that produces intermitting, or remitting fever. 

The symptoms attending acute inflammation of the liver are 
exceedingly diversified. Generally there is deep seated pain in 
the right side about the false ribs; wiiich is considerably aggra- 
vated by pressure. There is usually pain in the shoulder, and 
in some instances the pain is confined exclusively to that part. 
A deranged condition of the stomach and bowels always accom- 
panies this disease, attended with more or less nausea and vomit- 
ing. The stools are generally light coloured; and the urine 
yellow, or red. 

Professor Mitchell mentions the case of a boy whose liver was 
wounded by the discharge of a gun, in which no pain was expe- 
rienced except in the shoulder. In another instance, a negro 
who was run through the liver with a sword cane, complained 
of pain in the shoulder^ and insisted strongly that the wound was 
there. Pain in the shoulder is not, however, a constant attend- 
ant of inflammation of the liver. Neither does costiveness al- 
ways prevail, for sometimes there are acrid secretions from the 
liver, which cause purging. 

The skin is generally hot and dry, and has a very sallow ap- 
pearance. The patient can lie with ease on the affected side. 



INFLAMMATION OF THE LIVER. 



195 



As the disease advances, the nervous system becomes affected; 
there is great anxiety, and sometimes delirium. 

The duration of acute inflammation of the liver varies from 
four or five to ten or twelve days, wlien it terminates either in a 
restoration of the natural action of the organ, or in the formation 
of an abscess; or it may become a chronic disease. 

There is always more or less danger attending acute inflam- 
mation of the liver. Much, however, will depend upon the 
promptness of treatment in the early stages of the disease. 

Inflammation of the liver is frequently complicated with pleu- 
risy, and inflammation of the lungs. The stomach and bowels 
are always disordered, and probably, in the majority of in- 
stances, the stomach is diseased antecedent to the liver. 

Treatment. — Acute inflammation of tlie liver requires the same 
general course of treatment as pleurisy, or inflammation of the 
lungs. A full course of medicine must be given early in the 
disease, and repeated daily, if the symptoms be violent, until a 
crisis be effected. If the patient cannot sit up, a moist heat may 
be applied to the feet and around the body, in place of the vapour 
bath. The system should be relaxed by broken doses of lobelia. 
Injections are especially indicated, not only to relieve the bow- 
els, but to equalize the circulation, and also to effect a relaxa- 
tion of the system by lobelia administered in this w ay. 

Continued retching, and vomiting, by operating as a sort of 
exercise to the liver, has a beneficial influence upon it, enabling 
it to replace the loss of morbid secretions by more healthy ones. 

Stimulants must be given with a view to equalize the circu- 
lation; to maintain a determination to the surface; and to excite 
the secretions of the mucous membrane of the stomach and bow- 
els. More especially should pure stimulants be freely used in 
the advanced stage of the disease. Capsicum tea is the best 
stimulant; and if the skin be dry, portions of lobelia powder or 
tincture must be added. 



Local Jlpplicatiens. — A warm poultice must be applied to the 
affected side, and a hot brick, or a bottle of hot water placed so 
as to keep the poultice warm. 

The Diet must be light, consisting chiefly of gruel, barley 
water, crust coffee, &c. In the more advanced period of the 
disease, when the strength is greatly exliausted, it will be ne- 
cessary to give wine- whey and essence of beef. 

Bitters may be used to restore digestion, after the tongue be- 
gins to clean, or the disease has formed a crisis. 



196 



CHRONIC DISEASE OF THE LIVEE. 



The Symptoms denoting the formation of an Mscess in the 
Liver, are — irregular chills or rigours; pain and sense of full- 
ness in the region of the liver; and night sweats. When this 
group of symptoms is manifested after acute inflammation of the 
liver, of several days' continuance, it furnishes strong evidence 
that suppuration has taken place. The abscess may point to the 
surface and be discharged externally; or the pus may be dis- 
charged through tlie gall ducts into the bowels; or it may escape 
into the cavity of the abdomen, and occasion fatal jjeritonitis* 
Abscesses of the liver have in some instances penetrated the 
lungs and their contents discharged by coughing. 

An abscess having formed, the indications for the treatment 
are, — to support the strength of the patient by the use of pure 
stimulants and bitters, and by a nourishing diet. The articles 
of diet, however, must be such as are suited to the condition of 
the enfeebled digestive powers. 

2. Chronic Disease of the Liver, — Although acute inflamma- 
tion of the liver is of rare occurrence, yet no organ in the body, 
with the exception of the stomach, is moi*e liable to chronic de- 
rangement of its functions, than the liver. A disordered sto- 
mach is in almost every instance the cause of disease in the liver. 
A deranged liver is almost always a torpid one. Dyspepsia is 
mostly attended with a deficiency in the secretions of bile, from 
a want of proper circulation of blood through the liver. Cos- 
tiveness is in general the consequence of a want of bile, and the 
use of purgative medicines with a view to overcome a costive 
habit is worse than useless, as they aggravate and weaken the 
bowels, without restoring the action of the liver. The intem- 
perate use of alcoholic drinks is very apt to produce finally, tor- 
por of the liver, and in some instances this organ becomes 
greatly enlarged, as a consequence of intemperate habits. 

A disordered stomach lessens the nervous power which gov- 
erns the function of the liver, and consequently the circulation of 
the blood through the liver is enfeebled, and the secretion of bile 
diminished; and if the cause that occasions the disorder in the 
Jiver be continued, as in habitual drunkenness, the liver may 
lose its power to perform its functions, at least for a time, 
even though the habits of the person may have become reformed. 
The continued use of active cathartics, more especially of mer» 
curiai preparations, are pernicious, not only to the liver, but to 
the stomach and bowels. Close and intense study, confinement 
lly-ventilated apartments, and exposure to cold and dampness, 



m 



depressing passions, and excessive losses of blood, frequently 
occasion torpor of the liver. Derangement of the functions of 
the liver, however, are in most instances, but one link in a chain 
of disordered functions^ from less ^of vital power in the system. 



CHRONIC DISEASE OF THE XIVER. 19T 

Thus torpor of the liver is associated with acute disease, such 
as dysentery, cholera morhus, pleurisy, erysipelas, and autum- 
nal fevers. When patients are hied largely during an acute 
disease, tlie excessive loss of hlood may occasion torpor of the 
liver, continuing for years, accompanied witli dyspeptic symp- 
toms. 

If the dehilitating influence occasioning torpor of the liver he 
continued, the circulation will hecome moreohstructed and feehle, 
and finally the organ may lose its power to secrete hi!e, occa- 
sioning inveterate dyspepsia, dropsy of the abdomen, or jaun- 
dice. Hence disease of the liver which at first is but a link in 
a chain of disordered functions, and which may be readily cured 
by correcting the disorder of the stomach, may finally be the 
cause of a nerv train of disordered action througliout the system, 
requiring a long course of treatment to effect a cure. 

Symptoms attending chronic affections of the liver are extreme- 
ly diversified. The most obvious symptom indicating obstruc- 
tion to the flow of bile, is a yellowness of the skin and whites of 
the eyes. The liver, however, may have its functions greatly 
disordered, without there being any appearance of sallowness of 
the skin. Sometimes tliere may be a low grade of inflammation 
in the liver, occasioning shooting pain in the side and shoulder, 
accompanied with a dry, harsh, contracted state of the skin; loss 
of appetite, bad taste in the mouth, extreme restlessness at night; 
and dizziness of the head. In such cases digestion is always 
impaired, there is flatulency and distress after meals, attended 
with lieartburn, and constipation of the bowels. In some cases 
the patient will be affected with occasional diarrhoea, tlie stools 
presenting various appearances, sometimes clay-coloured; in 
other instances bilious; or they may be slimy and hard, or have a 
green appearance. Sometimes the liver becomes enormously 
distended and hard, filling at least half the cavity of the abdo- 
men, and its margins are distinctly felt by pressing the hand on 
the abdomen. 

Treatment — Depending for most part upon a disordered sto- 
mach, the indications for the cure of disease of the liver are, to 
correct the disordered condition of the stomach and bowels, and 
to warm and invigorate the system by the use of stimulants and 
tonics, and by a well regulated diet. 

Torpor of the liver may be more readily overcome in most in- 
stances by a course of medicine, than by any other means. If 
the disease become seated, it will be necessary in most cases to 
repeat the courses of medicine^ and during the intervals between 
them; to use bitters freely; and if the bowels be costive, take 



198 CHKOIs^IC DISEASE OF THE XIVBRr 

three or four of the compound lobelia pills after each meal and 
also at bed time. 

Adds, — Especial relief may sometimes be obtained by the 
use o^ pepper sauce, taken in moderate doses three or four times 
a day, and more especially at meals. 

The Vapour Bath by its influence in restoring the functions of 
the skin, may be employed with benefit in diseases of the liver 
or of any other internal organ. Thomsonians, therefore, in ap- 
plying remedies, do not require a particular investigation to as- 
certain the precise location of the disease, nor to know what 
name nosologists would very learnedly apply t(f it; for the same 
general treatment will be applicable to every other form of dis- 
ease. Thus the vapour bath which proves beneficial in curing 
disease of the liver, will be equally applicable to disease of the 
kidneys, bladder, lungs, pleura, bowels and head, and in fine it 
may be administered in almost any disease with safety, though 
it does not always pi'ove beneficial. 

Emetics, — The most efficient means to remove obstructions of 
the liver, in general, are the application of the vapour bath, fol- 
lowed by a prompt emetic. Cases of very stubborn character 
have been cured by continued vomiting from sea-sickness, the 
patient being in a relaxed condition, similar to that produced by 
the influence of lobelia upon the system. In cases of long stand- 
ing, however, and when the disease is associated with old age 
or an exhausted constitution, the frequent repetition of a course 
of medicine might be harassing to the patient, and fail to effect 
a cure. A change of organization in the liver having taken 
place, as it sometimes happens when the disease has been long 
continued, a palliation of the symptoms, by stimulants and tonics, 
is all that would be advisable by way of medicine, — as a radical 
cure, under such circumstances, is rarely to be accomplished. 

The functions of the liver maybe influenced to a greater or less 
degree by means of medicine operating upon the bowels. Hence 
injections will be useful, not only to relieve the bowels, but 
when properly prepared and administered, to exert a beneficial 
influence on the liver. Lobelia administered in tliis way, and 
retained, diff'uses its influence throughout the whole system, and at 
the same time that it occasions relaxation of the organs, it tends to 
restore their proper functions. Again, injections are useful to 
cleanse the bowels from morbid secretions, by which they are 
more or less coated, in nearly, if not in all cases of seated disease, 
with but little regard to name or location. The morbid secre- 
tions alluded to, usually pass off" in the form of flakes, and some- 
times in pieces, from a few inches to a foot, or even a yard in 



CmiONIC DISEASE OF THE IIVER. 199 

length, having somewhat the appearance of an intestine. Pa- 
tients not aware of the frequency of its occurrence, sometimes 
become alarmed at the passage of this kind of substance from the 
bowels. There are, however, few if any recoveries from seated 
disease, in which there has not been more or less of this morbid 
secretion passed from the bowels. 

Foot Bath, — The following mode of preparing and using a 
foot bath, is recommended by many practitioners who have tried 
it, namely : 

" Into a glass vessel, capable of holding a pint or more of 
fluid, put eight ounces of water, and then pour in four ounces of 
nitric, and the same quantity of muriatic acid. One ounce of 
this mixture to a gallon of water will form a bath of medium 
strength. The feet and legs of the patient are to be immersed 
in this bath at the temperature of about 96°, and kept there 
twenty minutes or half an hour, just before going to bed. This 
should be done every night, and the same bath will remain good 
for five or six nights," The utility of the warm foot bath cannot 
be doubted, and as there can no harm arise from the use of the 
acids, they should be added as above directed. 

If the tongue be coated with fever, a strong decoction of the 
bayberry or sumac, with the addition of a teaspoonful of compo- 
sition powder, or half the quantity of capsicum, may be taken 
once or twice a day. 

The use of bitters is indicated in chronic affections of the 
liver. If there be any cases in which the bitter root (apocy- 
num androsoemifolium) may be used with advantage, it is in 
chronic affections of the liver. It must be given in pills, or the 
powder, taken in luke-warm water, but not in sufficient quan- 
tity to produce purging. 

In every form of seated disease, when medicine is required, 
for many weeks, or even months, in succession, an occasional 
change of remedy for an equivalent one, will be proper. 

Dandelion, — The dandelion, either in the form of an extract 
or decoction, may be used with especial advantage in chronic 
disease of the liver. 

I have observed symptoms indicating extreme torpor of the 
liver, brought on by retirement from active business. In such 
cases the patients should resume their former active habits. 



SECTOJT It* 



JAUNBICE. 

A DISEASED condition of the system is sometimes atteiided 
"with obstruction of the natural passage of the bile, occasioning 
a yellow tinge in the skin and whites of the eyes, which is 
iermeil jmtndice. 

The digestive powers are always more or less weakened, and 
general coldness and torpor of the system prevails before the 
symptoms of jaundice appear. The suspension of the flow of 
bile may arise either from obstructions in the gall ducts; from 
coldness and torpor of the liver, or from deficiency of nervous 
power; yellowness of the skin being merely a symptom arising 
from obstruction in the passage of bile into the bowels. A jaun- 
diced appearance of the skin is very commonly observed in low 
forms of fever, arising from suppression of bile; thus yellow fe- 
ver, as it is termed, receives its name from the yellow colour of 
the skin. 

** When peoplehave what is called jaundice," says Dr. Thom- 
son, ^' it is the prevailing opinion that they have too much bile, 
and it is said they are bilious. This is a mistaken notion, for 
there is no such thing as there being too much gall : it would be 
more correct to say there was not enough. The difficulty is 
caused by the stomach being cold and foul, so that the food is 
not properly digested; and the bile not being appropriated to 
its natural use, is diffused through the pores of the skin, which 
becomes of a yellow colour." 

Symptoms. — The most obvious symptoms in jaundice, are 
yellowness of tlie skin and whites of the eyes, loss of appetite, 
bad taste in the mouth, costive bowels, high coloured urine, en- 
feebled mental powers, and a dry state of the skin. The pulse is 
frequently unaffected : it is sometimes slower, and at other times 
quicker than natural. Yellowness of vision is frequently one of 
the first symptoms indicating tlie approach of jaundice, wiiich 
may arise from the humours of the eye becoming tinted with the 
yellow colouring matter of the bile, and transmitting yellow rays 
of light. The patient is generally either restless and unable to 
sleep, or continues in a state of somnolency or stupor. 

The Colour, in jaundice may vary from a light yellow to that 
©fa deep green, or almost black. 



JAtJNDICE. 201 

Location. — Jaundice is sometimes confinecl to the face and neck, 
In other instances it is diffused over the whole surface of the 
body and limbs. 

The Approach of Jaundice.— GenersiW j the disease comes on in 
a gradual manner, associated with symptoms of indigestion; *'a 
general feeling of languor; disinclination to bodily and mental 
exertion; an irritable and dejected temper; weakness of appe- 
tite; constipation; acid eructations; slow and painful digestion; 
flatulent pains in the bowels; a slight feeling of fulness and ten- 
sion in the epigastrium, (pit of the stomach); restlessness at 
night; a turbid urine, usually depositing a copious pitchy sedi- 
ment; slow and languid pulse; more or less nausea; and frequent 
transient chills, alternating with flushes of heat." After these 
symptoms have continued for a few days, a disagreeable itching 
over the whole body takes place; the taste becomes bitter; the 
stools whitish or clay coloured; the urine of a deep saffron hue; 
and finally the whites of the eyes, and the skin about tiie lips, 
neck, and forehead, assume a yellow colour, which speedily ex- 
tends itself until the whole surface acquires an uniformly yellow 
hue. 

Sometimes the disease comes on suddenly, with severe pain 
and distress at the pit of the stomach, attended with frequent vo- 
miting, and an entire disgust for food. 

The duration of an attack of jaundice is extremely varied. In 
some instances it passes away in the course of a few days, whilst 
in others it will continue for months, and occasionally the dis- 
ease assumes the chronic form, in consequence of permanent de- 
rangement of the digestive functions, and continues for years ac- 
companied with symptoms of dyspepsia. 

Treatment. — Jaundice being merely a symptom, arising from 
previous disease, it is to be overcome, or removed by correcting 
the derangement of the general health. 

The symptoms being violent the treatment must be thorough 
and early applied. A course of medicine should be given, and 
repeated every day or every other day, until the symptoms be- 
come more favourable. Besides a course of medicine, the com- 
pound lobelia pills may be given, together with an occasional 
dose of capsicum in composition. 

Tonics.— The most powerful kinds of bitters are required in 
jaundice. In sudden and violent attacks, the bitters may be em- 
employed after the symptoms abate, but when the disease comes 
on in a gradual manner, they may be employed from the first, in 
combination with stimulants. A tablespoonful of the expressed 

2 A 



20^ JAUNDICE. 

juice of green wormwood, added to an equal quantity of whiskey^ 
taken three times a day before meals, has been used by some 
with special benefit. 

Dr. Thomson in treating of jaundice, says: '^ Ihave attended 
many cases of this kind, and never had any difficulty in effecting 
a cure. My method is to give No. 2, or the composition pow- 
ders, to raise the internal heat, and No. 1 to cleanse the stomach, 
and promote perspiration; then give the bitters, No. 4, to regu- 
late the bile and restore the digestive powers. If the complaint 
has been of long standing, and the system is much disordered, 
they must be carried through a regular course of medicine; and 
repeat it as occasion may require^ and at the same time give the 
bitters two or three times a day, until the appetite is good and 
digestion restored.^' 

Sometimes jaundice is occasioned by gall stones being lodged 
in the gall ducts, attended with violent paroxysms of pain in the 
right side, near the pit of the stomach, and continued straining ef- 
forts to vomit, the stomach at the same time forcibly rejecting 
any thing that is swallowed. In a case of this kind, the vapour 
bath must be applied; and the system placed in a state of relax- 
ation by lobelia administered by injections; together with full 
and frequent doses of the third preparation of lobelia, until the 
symptoms are relieved. Gall stones have been removed in many 
instances, by the operation of emetics. 

Straining efforts to vomit, when the system is warmed by the 
vapour bath, or by the application oi liot bricks wrapped in 
damp cloths, around the patient, and relaxed by the influence of 
lobelia, will form the surest means of removing obstructions, 
either in the gall ducts, or in the liver. 

A warm stimulating poultice, applied to the pit of the stomachy 
will relieve the pain. 

The warm foot bath, prepared in the manner described in the 
treatment for chronic disease of the liver, has been used with 
marked advantage in jauncice. 

Celandine, agrimony, blood root, liemp seed boiled in milk, 
besides many other articles and compounds, have been recom- 
mended as specific remedies for jaundice, not one of which, how- 
ever, can be relied upon. Although patients may recover from 
jaundice, under the use of celandine, hempseed, or some other of 
the reputed specifics, there is no evidence that the disorder would 
not have been removed sooner under Thomsonian treatment I 
have known jaundice cured by Thomsonian treatment after vari- 
ous other remedies and modes of treatment had been tried with- 
out success; but I have yet to see the first case cured by other 
treatment, after the Thomsonian practice, judiciously applied^ 
has failed. 



APOPLEXY. £03 

Change of Air. — In seated disorders, a change of residence 
will frequently be attended with a decided improvement in the 
general health. 

Biet — In jaundice the digestive powers are always weak, and 
tlierefore a strict attention to diet must be observed. In the 
commencement of the disease, and more especially if the symp- 
toms be violent, the diet should be confined to the lightest kinds 
of food. In cases of long standing, it may be more nourishing, 
but it must be easy of digestion. As a general rule, in jaundice, 
butter, and all kinds of fat meats disagree with the stomach. 

Attacks of bilious colic are frequently accompanied with a 
jaundiced hue of the skin, and whites of the eyes. And in fe- 
males there is sometimes a yellow tinge in the skin, after an 
attack of hysteria. The same general course of treatment, how- 
ever, will be adapted to all cases. 



CHAPTER VII. 



SECTION lo 



APOPLEXY. 



Symptoms. — A sudden suspension of consciousness; a loss of 
the power of voluntary motion; stupor; heavy and laborious 
breathing; and a slow and full pulse, are the symptoms whicli 
characterize apoplexy. 

An attack of apoplexy occasionally comes on suddenly, with- 
out any precursory symptoms. More commonly, it is pre- 
ceded by giddiness, and a sense of weight and deep seated pain 
in the head, ringing in the cars, aiul dimness of sight. These 
symptoms may occur a few hours, or they may continue for a 
week, or even for months previous to the attack, and occasion- 
ally tbey di&appear without the occurrence of an apoplectic fit- 
In some cases the attack comes on suddenly^ the patient sink- 
ing at once into a profound stupor, from which he cannot be in 
any degree aroused — resembling a deep sleep — and each expira- 
tion attended with a puffing of the lips, and a frothy saliva blown 
out with a sputtering noise. These cases generally prove fatal 



204 APOPLEXY. 

in a few hours. In other cases, the patient may be seized with 
deep seated pain in the head; sickness and vomiting; tremor of 
the limbs; dizziness; confusion of mind; and then gradually 
sink into a state of stupor, from which he will partially recover, 
so as to converse, and be able to sit up, and probably walk about, 
but will still complain of pain and distress in the head, attended 
with giddiness and confusion of ideas. After a few hours the 
brain becomes oppressed, and a state of complete insensibility 
ensues. 

Sometimes an attack of apoplexy comes on with palsy of one 
side, loss of speech, pain in some part of the head, and vertigo, 
— the patient retaining his consciousness. By degrees, the 
brain becomes more oppressed and consciousness is gradually 
lost, until finally a deep stupor ensues. 

Deep intoxication sometimes so nearly resembles apoplexy 
that it may be difficult to distinguish between them. The breath, 
however, will detect intoxication, together with the relaxed state 
of the muscles, particularly those of the jaws, the reverse of 
which occurs in apoplexy. 

In cases of suspended animation and fainting, the pulse and 
respiration is almost imperceptible, whereas, in apoplexy, the 
pulse is strong, and respiration full. 

»Bpoplexy always Dangerous,— When there is a total loss of 
consciousness, the respiration accompanied with deep snoring, 
a sputtering from the lips, loss of the power of swallowing, 
and the eyes fixed, the case may be considered as almost hope- 
less. Still we are informed that recoveries do take place, even 
after these symptoms have occurred. 

Duration of the Apoplectic attach — This varies from a few 
minutes to several days. Death seldom takes place before the 
second and third hour, and in some cases not until the fourth or 
sixth day from the commencement of the attack. 

Medical writers of extensive observation, among whom I may 
mention Hippocrates, consider the occurrence of fever, in the 
early stage of apoplexy, a favourable symptom. Where the 
pupil of tlje eye will contract by the near approach of a lighted 
candle, when there is a warm and gentle perspiration, the breath- 
ing free and regular, without noise or sputtering, together with 
the ability to swallow, a gentle diarrhoea, or when a copious dis- 
charge of urine is observed, hope may reasonably be entertained 
of a recovery. 

Cause of Apoplexy — -The immediate cause of apoplexy in most 
instances, is pressure upon the brain, suspending the function of 
innervation, or the generation of nervous fluid. 



APOPLEXY. 205 

One whose conformation of body is corpulent, with short neck 
and large head, and whose advanced age, or intemperate habits 
have rendered his vital powers weak, will be liable to apoplexy 
from various causes. 

The most usual exciting cause of apoplexy is over distention 
of the stomach by excessive indulgence in eating food of difficult 
digestion; together with the intemperate use of alcoholic li- 
quors. 

Exposure to extreme cold, by exhausting the heat of the body, 
and causing the blood to recede from the surface and form in- 
ternal congestion, is capable of producing apoplexy. 

Severely protracted chills have been observed to give rise to 
this disease. 

Positions of the body which favour a flow of blood to the head 
or impede its return to the heart, stooping with the head low, 
lifting great weights, and wearing tight corsets have been known 
to bring on a fit of apoplexy. 

It is only, however, where the predisposition to apoplexy 
exists, that it is liable to be brought on by such causes. 

Among tlic occasional causes of apoplexy may be mentioned, 
excessive evacuations. The celebrated Boerhaave cites a case 
of apoplexy, apparently produced by excessive bleeding from the 
nose. Diabetes and cholera sometimes terminate fatally with 
symptoms of apoplexy. Excessive loss of blood is frequently 
followed by an extraordinary determination of blood to the brain. 
Experiments which have frequently been tried on animals by 
abstracting large quantities of blood, and finally by bleeding 
them to death, go to prove, as has been observed on dissection, 
that dropsy, together with an engorged state of the blood vessels 
of the brain and spinal marrow, are a general consequence of ex- 
cessive losses of blood* 

Treatment — Such means and remedies are indicated in the 
treatment of apoplexy, as are best adapted to equalize the cir- 
culation of the blood throughout the system, and restore the 
functions of the brain, which are always suspended in this 
disease. 

Injections, — These are of the first importance in the treatment 
of apoplexy. The third preparation of lobelia should be em- 
ployed, or some other combination of lobelia; — for instance: the 
lobelia powder and No. 6. One, two, or three tablespoonsful of 
the third preparation of lobelia may be administered at a time, 
in half a pint of luke-warm water, composition, orbayberry tea. 
This must be frequently repeated, with a view to attract the cir- 
culation from the head; and thus lessen the pressure of blood 



I 

I necessary. 



206 APOPLEXY. 

upon the brain, and to arouse the nervous energy of the system 
to carry on the circulation with healthy activity. 

Emetics. — If a patient have an attack of apoplexy within a 
few hours after a hearty meal, free vomiting will he imperatively 
demanded. The third preparation of lohelia must be poured into 
the mouth, and will be much more likely to be swallowed than a 
preparation of lobelia less stimulating. The impresssion of a 
powerful stimulant in the throat will excite the act of swallowing, 
and the medicine will be taken into the stomach, when the lo- 
belia powder in luke-warm water, or composition tea would fail 
to excite the act of swallowing, whilst the patient is uncon- 
scious. When the functions of the brain are suspended, as they 
are in apoplexy, large doses of medicine will be required in or- 
der to effect vomiting; or as an efficient aid to excite vomit- 
ing, the lobelia powder may be administered by injection in 
luke-warm water and retained. A tablespoonful of the powder 
may be used in the injection which must be repeated promptly if 



External Jlpplications, — "Warm applications to the feet, fric- 
tions to the surface, cold applications to the head, the vapour 
bath applied to the lower half of the body, and the surface bathed 
frequently with stimulants — -pepper sauce. No. 6, or the third 
preparation of lobelia — constitute the external means proper to 
be employed in the treatment of apoplexy. The head must be 
kept elevated, and the pillow occasionally turned over, or 
changed for another to keep the head sufficiently cool. 

*^ A robust man," says Dr. Eberle, ** about iifty years of age 
fell down in a fit of apoplexy about an hour after taking a full 
meal of animal food, together with several glasses of brandy and 
water. The coma was profound, and the respiration sterterous 
and sputtering. He was immediately bled to the extent of about 
forty-eight ounces, but although the pulse was considerably re- 
duced, no perceptible improvement ensued. Twenty grains of 
the sulphate of zinc were with ditliculty introduced into the sto- 
mach, and free vomiting ensued in about ten minutes after. Al- 
most immediately after the contents of the stomach were thrown 
off, he became better." The patient recovered. The sulphate 
of zinc, being an active poison, would have proved detrimental 
had it not been speedily thrown off. On account of the danger 
attending the administration of active poisonous emetics, most 
medical writers recommend milder articles, — camomile tea, 
ammonia in water, or mustard in warm water. But tlie sensi- 
bility of tlie stomach is generally too dormant to be acted upon 
by these milder remedies. Apoplexy, however, is a disease 
which frequently baffles all remedial means. 



JPARALYSIS. 207 

Favourable Stjmptoms*— -When the stupor becomes less pro- 
found, with some degree of awakened sensibility; the breathing 
regular and not sterterous, or sputtering from the lips; together 
with a general warm perspiration, some hope may be entertained 
of a favourable issue* 

Preventive Measures. — When symptoms arise wliicli denote 
the approach of apoplexy, such as headach and giddiness, dim- 
ness of sigiit, numbness of the extremities, drowsiness, faltering 
of the tongue, night mare and stupor, a course of medicine should 
be given as the most efficacious means of preventing an attack. 



SECTION" II. 



PARALYSIS.—PALSY. 



Symptoms. — These are a loss of the power of voluntary mo- 
tion, sometimes of feeling, in one half or some portion of the 
body, the patient not losing his consciousness. 

In some instances there is loss of the power of motion, but 
without loss of feeling in the parts. In other cases sensibility 
and the power of motion are both lost. This is termed numb 
palsy. 

In general the paralysed parts are colder than other parts of 
the body; they become soft and flaccid, sometimes pnffy and 
dropsical. Yery often patients complain of great coldness in 
the affected parts. Sometimes a peculiar tingling, or creeping 
sensation is felt in the affected parts, as if small insects were 
creeping over them." 

*• When palsy arises from disease of the brain, it is generally 
attended witli an impairment of the mental powers — amounting 
in some instances, to complete imbecility. The memory espe- 
cially, is apt to suffer in this affection; and sometimes in a very 
singular manner." Thus some patients will lose the power of 
recollecting certain words, or names, sometimes even their own 
names,, the memory being gone in relation to other things." — 
*'The natural temperament and disposition also sometimes suffer 
a total change from a stroke of palsy. Individuals of amiable 
and placid dispositions have become sullen, peevish and irrasci- 
ble; and persons of an irritable and passionate temperament, 
have been rendered mild and simpering by a paralytic seizure. 



mmim 



208 PARALYSIS. 



Varieties of Palsy. — Paralysis of the whole of one side of the 
body is called Hemiplegia, 

When both legs and the hips are palsied, it is termed Fara- 
plegia. 

When a single limb, or a particular part of the body is para- 
lysed, it constitutes the Paralysis Partiales of authors. 

1. Hemiplegia — Palsy of one side.—Valsj of one side of the 
body is more observed than any other form. ** this disease is 
very closely allied to apoplexy," the latter being in general a 
more severe form of disease. An attack of apoplexy is very 
often either preceded or followed by palsy. ' 

Generally a stroke of palsy is preceded by symptoms of con- 
stitutional disturbance, loss of appetite, costive bowels, distress 
or extreme insensibility of the stomach, giddiness and pain in 
the head, continual drowsiness, more or less impairment of 
speech, confusion of mind, and loss of memory. 

Palsy is not a very fatal disease. — Sometimes patients recover 
from a stroke of palsy in a few days after the attack; occasion- 
ally the disease terminates fatally, but most commonly the pa- 
tient recovers gradually, until he is ahle to move about, contin- 
uing in this state in some instances many years without further 
improvement. Sometimes the recovery is complete. 

Paraplegia — Palsy of the lower half of the body. — This form 
of palsy usually comes on in a gradual manner. The patient at 
first experiences numbness in the legs, succeeded by more or less 
difficulty in walking: his gait is awkward, and he requires a 
cane to assist in balancing his body. The bladder becomes more 
or less paralysed, the urine being voided in a small weak stream, 
and at length passes off involuntarily. The bowels are gener- 
ally constipated; but when the sphincter muscle of the anus be- 
comes paralysed, the foeces are evacuated without the consent 
of the will. In some cases the palsy is complete, the patient be- 
ing unable to walk, or even to support himself in a sitting pos- 
ture. In other instances the patient retains some degree of 
power over the motions of his legs, so that with the assistance of 
a cane or crutches, he is able to move about. 

In persons past the age of forty, this form of palsy is gener- 
ally occasioned by disease of the brain. In children, the para- 
lysis is in most instances caused by injuries of the spine. 

2. Partial Palsy. — Sensibility and voluntary motion depend 
upon a nervous fluid, which is generated at the great centres of 
the nervous system, the brain and spinal marrow, and is con- 
ducted from these centres to every part of the system, through 
the medium of the nerves, which act as conducting wires to the 



FAISY* 209 

nervous fluid. Tliere arc nerves of motion/and there are nerves 
of sensation. If a nerve of motion be cut, the part to which it 
is distributed will become paralysed. And if a nerve of sensa- 
tion be destroyed, or injured so that it is incapable of conduct- 
ing the nervous fluid, the part to which it leads will lose the 
power of feeling* If a portion of the brain or spinal marrow 
lose the power to generate nervous fluid, that part of the body 
will become affected whose nerves arise from that part. Thus 
one side of the body having lost the power of feeling, we know 
that the disease is seated in that portion of the spinal marrow in 
which its nerves of sensation originate. If that portion of the 
spinal marrow from whicli the nerves of motion arise, is dis- 
eased, the parts will become paralysed to which they lead. And 
if both tbe anterior and posterior columns of one half of the spi- 
nal marrow lose their functions, that side of the body will be af- 
fected with loss both of motion and feeling. 

In partial palsy, when a single muscle or small portion of the 
body is paralysed, it is generally owing to disease in the nerve 
which is designed to distribute nervous power to the part. 
Paralysis of one side of the face alone, is sometimes occasioned 
by injury of the nerves leading to the part affected. 

Of the Causes of Palsy, ---A loss of power in the stomach is 
frequently the original cause of palsy, more especially when the 
disease attacks one side of the body. Although the immediate 
cause of paralysis is a loss of function in some portion of the 
brain or spinal marrow, still the original cause in most instances, 
is seated in the stomach. The functions of the brain and spinal 
marrow, as well as those of every other organ in the body, are to a 
greater or less degree influenced and governed by tlie state and 
condition of the stomach. Thus a person advanced in years, and 
predisposed to palsy from a weakened condition of some portion of 
the brain or spinal marrow, will be liable to an attack of it from 
prostration of the powers of the stomach. Both apoplexy and 
palsy are frequently brought on by undigested food in the sto- 
mach, long continued exposure to severe cold or to dampness, 
the intemperate use of spirituous liquors, loss of rest, over exer- 
tion, grief, fear, and by otlier depressing influences, all of which 
operate to disorder the functions of the brain, through the 
medium of the stomach. 

^^ Among the exciting causes oi pa^^tial paralysis^ the poison- 
ous influence of lead is the most remarkable. The tendency of 
this article, to produce paralysis of the fore-arm and wrists, is 
peculiarly strong, as is evident from the frequent occurrence of 
palsy in persons who work in lead mines, plumbers shops, and 
in manufactories of wiiite lead. 

2B 



210 PALSY. 

Treatment of Falsi] . — la the early stage of palsy, a vigorous 
course of treatment is demanded, with a view to restore the lost 
function of that portion of the hrain or spinal marrow, the im- 
mediate cause of the disease. Whether the loss of nervous power 
be occasioned by pressure of blood upon the parts, or from loss 
of power through mere debility, or even should it depend upon 
disease originally seated in the brain, a course of medicine will 
be especially indicated, besides the continued use of such reme- 
dies and means as will prove most successful in equalizing the 
circulation, and restoring the vitality of the stomach and bowels. 

The Course of Medicine should be commenced with an injec- 
tion. In most instances the bowels are extremely insensible, re- 
quiring the injections to contain strong stimulants, in order to 
produce the desired effect. A tablespoonful of the third prepa- 
ration of lobelia, in half a pint of bayberry tea, forms a suitable 
injection in palsy, though in some instances double or treble the 
above quantity will be required, in order to make a sensible im- 
pression upon the bowels. 

When the patient is unable to sit up, the vapour bath will of 
course be applied in bed. It is always better to steam the patient 
on a couch or mattress, and thus avoid dampening the bed upon 
which he usually lies. Patients upon a couch or cot-bed will 
bear the continued application of the vapour for several hours in 
succession; the body to be w ashed over frequently with whiskey 
vinegar, or simple cold w ater during the steaming. 

When the patient is so situated as to be able to bear the steam 
a considerable length of time, an emetic should be given during 
the process of steaming. The best form of an emetic is the liquid 
of the third preparation of lobelia, adding a portion of brown 
lobelia powder, and given in a strong tea of the bayberry or su- 
mac. I have observed more benefit from emetics than from any 
other means. To assist the operation of the emetic, and to bring 
the system more completely under the influence of lobelia, it will 
be highly important to administer an injection of lobelia powder, 
in luke-warm water. The course of medicine proves most ef- 
fectual when the patient becomes very sick, and the system is 
fully relaxed under the operation. 

The Compound Lobelia Fills may be used with benefit. I have 
a case of palsy now under treatment, and the patient has so far 
recovered as to be able to w alk. The use of tlie above pills, to- 
gether with an occasional emetic and the steam hath, followed by 
a shower hath two or three times a week has constituted the prin- 
cipal treatment in this case. She is now using bitters, and the 
bowels are relieved by injections. 

Palsy, however, is a disease from which patients recover very 



PALSY. 211 

slowly, and therefore, in deeply seated cases, it will not be ne- 
cessary to pursue a very thorough course of treatment, except 
during the earlier stages of the complaint. Thus after admin- 
istering a few courses of medicine, repeating them every day, or 
every few days, the course of medicine may be omitted, ex- 
cept occasionally, say at intervals of one, two, or three weeks, 
as the circumstances of the case may seem to require. 

When there is oppression at the pit of the stomach, fever, foul 
tongue, or general distress, an emetic should be given. 

Capsicum is the best remedy to warm the stomach and bowels 
and restore the secretions of the mucous membrane. It may be 
taken in in the form of pills, powder, or decoction. The com- 
pound lobelia pills contain a large portion of pepper, and an- 
swer as a substitute for other preparations of pepper. In all 
cases of palsy, the mucous membrane of the stomach and bowels 
is more or less coated with morbid secretions, which must be 
removed, or otherwise the disease will continue. When the 
tongue begins to clean around the edges, or the coating which 
covers its surface begin to soften, then the capsicum should be 
taken in bayberry tea. The pepper stimulates the secretions, 
sustains the circulation, and causes a determination to the sur- 
face; the bayberry combining with other foul secretions of the 
stomach and bowels, causes them to become detached, leaving 
the mucous surface clean. 

A mixture of salt^ vinegar and pepper ^ is grateful to the sto- 
mach in many cases, and is usually found beneficial where the 
patient craves acid. The pepper sauce, or simple salt and vine- 
gar, may be employed in many cases of disease, with signal bene- 
fit to the patient. 

In palsy the bowels are generally costive, requiring an occa- 
sional injection. In palsy of the lower half of the body, the most 
powerfully stimulating injections will be required, in order to 
make a sufficient impression upon the bowels. 

Mustard Seed — A tablespoonful of white mustard seed taken 
two or three times a day will stimulate the bowels to action, and 
is well suited to cases of palsy. 

Mustard Seed and Horse-Raddish were favourite remedies with 
the late Dr. Barton, of Philadelphia, wiio used them wdth much 
advantage in the Pennsylvania Hospital. 

Tonics. — In an advanced period of the disease, or when the 
system is in a relaxed and feeble condition, strong tonics will be 
required; such as Peruvian bark, quinine, Thomson's No. 4 
bitters, wormwood, quassia. Prickly ash bark or berries may 
be added to the bitters. 



S12 PALSY. 

External Remedies, — Besides the vapour and shower baths 
there should be a continued application of warmth to the affected 
side; the skin occasionally to be bathed with pepper sauce, third 
preparation of lobelia, stimulating liniment, or No. 6. Fric- 
tions of the surface with a flesh brush or salted towel, two or 
three times a day will be of advantage. Occasionally a pepper 
poultice or mustard plaster may be applied to the nape of the 
neck, extending eight or ten inches down the spine. When mus- 
tard is applied, it should not reiirain on so long as to produce a 
blister. 

Paraplegia — (Palsy of the lower extremities,) requires the 
same constitutional treatment as above described, adapting the 
remedies, however, to the circumstances of the case- 

The bladder is frequently paralysed in this form of palsy, 
sometimes requiring the use of a catheter, to prevent an over 
distention of the bladder. The bowels require stimulating injec- 
tions, and the free internal use of compound lobelia pills, and 
capsicum, or pepper sauce. 

The Hip Vapour Bath is adapted to this form of palsy. The 
parts, however, being in some instances devoid of feeling, are 
liable to be scalded by the steam unless particular attention is 
paid to regulate its temperature. Especial care will also be 
necessary to prevent the feet from being burned by hot bricks 
when they are placed near them. 

Children are sometimes affected from birth Avith unusual de- 
bility, and want of power over the legs. Such cases require the 
cold salt water bath, or shower bath, frictions of the surface 
with a salted towel, fresh air, wholesome food, stimulating ap» 
plications to the skin, together with internal constitutional reme- 
dies, when the general health is bad. If the digestion be feeble, 
or the bowels disordered, with a foul tongue and bad breath, an 
emetic must be given, repeated when necessary, and mild tonics 
used — spice bitters, poplar bark tea, or gentian. 

Palsy of the lower half of tlie body, when of long standing, is 
often incurable. It is therefore important to institute a thorough 
course of treatment in the early stage of the disease, before it be- 
comes immovably fixed. Palsy, however, sometimes arises from 
causes that cannot be removed, even though prompt remedial 
measures be early applied. 

For Falsy of the Tongue the patient should keep some stimu= 
lant in the mouth, such as pepper, ginger, cloves, conserve of 
hollyhock, &c. In severe cases the third preparation of lobeliss 
must be employed. 



PALSY. 213 

In Paralysis of the Optic JSTerve, termed amawrosis, a course of 
medicine frequently repeated in the early stage of the disease, 
will prove the most efficient means of cure. This disease fre- 
quently originates in a disordered stomach. It is not every 
case of amaurosis, however, that can he cured even by the most 
prompt and persevering course of treatment. 

Palsy of one side of the Face has been cured by emetics. A 
full course of medicine will be more effectual. If the paralysis 
arise from a destruction of the nerve, as when the nerve is cut, 
there is, of course, no cure for such a case. 

Mercurial Tremor — (Shaking Palsy.) — ^^This disease affects 
workers in mercury, ^ — chiefly those employed in silvering mir- 
rors." 

Symptoms, — At first there is slight tremor in the limbs, and 
sometimes salivation; <' afterwards convulsive agitation of the 
limbs whenever they are moved. The articulation becomes im- 
perfect. The hands are so agitated, that a partly filled cup 
cannot be conveyed to the mouth without spilling the liquid. 
On attempting to walk, the limbs dance and perform irregular 
movements. Whilst sitting still, the patient may remain free 
from chorea; but on every exertion of the volition, and on every 
occasion of mental agitation, the irregular movements are re- 
newed. The sleep is disturbed; the patient wakes alarmed by 
terrific dreams; nervousness and debility attend; and the bow- 
els are constipated. 

Treatment. — In the onset of the complaint, a removal from the 
influence of the cause; vapour baths, and an occasional course 
of medicine, together with stimulants and tonics, and exercise in 
the open air, may succeed in effecting a cure, or at least prevent 
it from getting worse. 



SECTIOT?^ III. 



EPILEPSY. 



(convulsion fits — FALLING SICKNESS.) 

An attack of this disease is characterized by a loss of con* 
sciousness, and by a jerking or convulsive motion of the muscles. 
Sometimes the fit comes on suddenly, without any previous 
symptoms indicating its approach; at other times it is preceded 
by various symptoms of constitutional disorder, with giddiness, 
stupour, pain in the head, and confusion of mind. Some patients 
experience a sensation like that produced by a stream of cold va- 
pour, commencing in the feet and gradually extending itself until 
it reaches the head, when the patient immediately becomes insen- 
sible. If the patient be standing or sitting when he is seized 
with a fit, he suddenly falls and is totally insensible, the eye- 
balls are distorted, the breathing greatly interrupted, the face 
swells, and convulsions ensue, which generally continue from five 
minutes to half an hour. In some cases the convulsive action 
of the muscles, particularly those of the face, are frightfully vio- 
lent; the whole face is agitated; the eyeballs roll; the lips and 
eyelids are convulsed; the tongue is often spasmodically thrust 
from the mouth, which with the grinding of the teeth, and foam- 
ing at the mouth, gives the countenance a horridly wild expres- 
sion. Sometimes the teeth are firmly pressed together; at 
other times the jaws are widely and fixedly distended. The 
limbs of both sides of the body are equally convulsed in some 
cases, but more frequently the muscular powers are stronger on 
one side; and occasionally one limb only is affected with spasm. 
<*The heart palpitates rapidly; the pulse is usually contracted, 
irregular and frequent; and respiration oppressed, laborious, 
and in violent cases, sonorous. About the termination of the 
paroxysm, a considerable quantity of frothy saliva usually flows 
from the mouth; and in some cases the foeces and urine pass off 
involuntarily." Sometimes the convulsions stops uddenly, but 
more commonly they decline gradually. The breathing becomes 
more free, the countenance assumes a more natural aspect, and 
the patient falls into a profound sleep. The patient is languid 
and stupid, and when he awakes, he has no recollection of what 
has passed. 



EPILEPSY. 213 

The character of an epileptic fit varies greatly in different 
cases. In some instances it passes off in a few seconds — in 
others it continues for hours. The paroxysm is most apt to be 
protracted in children. 

Some patients are subject to convulsions at night only; others 
are liable to an attack at any period of the day. With some, the 
fits come on at regular intervals. Dr. Eberle mentions a case 
where the paroxysm returned regularly on the night of each full 
moon. 

Sometimes there will be but one paroxysm. In other instances 
the patient will have them in continual succession during a peri- 
od of many hours, sometinles passing from one into another, un- 
til he has had twenty, forty, or even sixty fits, in the course of 
twenty-four hours. 

Causes. — Convulsions may be caused by disease seated exclu- 
sively in the brain or spinal marrow; or the epileptic paroxysm 
may be induced by a disordered condition of the stomach or bow- 
els, the functions of the brain being thereby sympathetically de- 
ranged. Sudden fright has been known to bring on epilepsy. 
Excessive loss of blood has frequently led to convulsions. 

In children, convulsions are often occasioned by undigested 
food in the stomach, and from worms in the stomach or bowels. 

In some families the children are peculiarly liable to convul- 
sions during the period of teething. 

Small-pox, scarlet fever, and measles are occasionally attended 
by convulsions, more especially just before the eruption appears; 
and also when the eruption leaves the surface for the internal 
organs, or as it is commonly expressed, when the disease strikes 
in. The use of laudanum predisposes children to epilepsy. 
Suppressed menstruation, and diseases of the uterine organs are 
sometimes attended with convulsions. 

Venereal excesses and abuses, and the intemperate use of al- 
coholic liquors are among the exciting causes of epilepsy. 

Distinguishing Symptoms between Epilepsy and Hysteric Con- 
vulsions. — In epilepsy there is a total loss of consciousness, 
whereas in hysteria some degree of sensibility remains. 

2. The eyes are more distorted, and the face more suffused 
and livid in epilepsy than in hysteric convulsions. 

3. In epilepsy there is usually foaming at the mouth, which is 
absent in hysteria. 

4. In hysteria the paroxysm does not terminate in a deep sleep, 
as it does at the close of an epileptic paroxysm. 

5. Hysteric convulsions are generally attended by involuntary 
paroxysms of laughing or crying, and a sensation of a ball in 
the throat, none of which accompany epilepsy. Epilepsy and 



216 EPILEPSY. 

hysteria may proceed from tlie same cause, the symptoms heing 
of a more aggravated character in the former tlian in the 
latter. 

Treatment— An important indication in the treatment of epi- 
lepsy, and every species of convulsion is to overcome the spas- 
modic action of the muscles. The third preparation of lohelia is 
the remedy chiefly to be relied upon, this being the most efficient 
anti-spasmodic medicine in use. In many instances an attack 
of epilepsy may be prevented by the patient taking a tablespoon- 
ful or even a teaspoonful of the third preparation of lobelia, 
when the first symptoms of an approaching attack make their 
appearance. Many persons, however, have no warning of the 
approaching paroxysm, but fall suddenly into a state of insensi- 
bility. The third preparation of lobelia may be given during 
the convulsions, without any risk of strangling the patient, the 
stimulous of the medicine in the throat, sometimes exciting 
the action of swallowing, and thus the medicine will be easily 
taken into the stomach. When the third prepation is not at 
hand, the tincture or a simple tea of lobelia may be used. 

Emetics. — An oppressed or otherwise disordered stomach, is 
a frequent cause of convulsions in children demanding the use of 
emetics. If the convulsions be so strong as to prevent swallow- 
ing the medicine, it must be administered freely as soon as the 
paroxysm subsides, with a view^ to prevent a return of the con- 
vulsions. The third preparation of lobelia is the most efficient 
emetic. The lobelia, however, may be given in tincture, or the 
powder alone in luke-warm water. 

Injections. — These when rightly prepared and administered, 
are as effectual in overcoming convulsions, as medicine taken 
into the stomach. They maybe administered during theparox- 
ysm, provided the convulsions do not prevent it. 

In Mults who have been subject to frequent attacks of epilep- 
sy, during several successive years, the disease often proves in- 
curable. Yet an effort should be made, for in some instances 
cures have been effected, even under circumstances which have 
promised little hope of success. Whenever patients have warn- 
ing of an attack several hours previous to its occurrence, a course 
of medicine should be administered, and whilst steaming, keep 
the head wet with cold water, or vinegar, or occasionally dash 
a tumbler of cold water in tlie face. If a full course be not given, 
the feet of the patient may be placed in warm water — an injec- 
tion administered, followed by full and frequent doses of the 
third preparation or some other form of lobelia, and tlie head 
kept wet with spirits, vinegar, or cold water. A dash of cold 



water in tlie face, or the application of volatile salts to the nos- 
trils, will sometimes prevent an attack, at least for a time. 

Patients are apt to injure the tongue (luring the paroxysm of 
epilepsy, unless prevented by the insertion of a piece of wood or 
cork, between their teeth. In cases of long standing, it may be 
useless to attempt to do more during a paroxysm, than to pro*^ 
tect the patient from injury. 

Jfter a Paroxysm^ in children, and in all cases where there is 
reason to believe that the disease is occasioned by a disordered 
stomach or bowels, an emetic must be given as soon as the pa- 
tient can be made to swallow. If the stupor continue, injections 
must be administered. Vomiting may be effected in this way, 
by the lobelia powder, administered in warm water, and retained 
in the bowels. 

When convulsions are caused by suppressed menstruation, or 
a disordered condition of the uterine organs, the patient must be 
kept warm in bed, stimulating enemas used to the bowels, warm 
applications to the feet, and an emetic given whenever the symp- 
toms demand it. Thus, if a female be subject to epilepsy or 
even hysteria, at a certain time in the month, she should go 
through a course of medicine a day or two previous to the time 
%vhen the paroxysm is apt to occur, and continue for several days 
the use of the means above mentioned. 

Epilepsy is generally incurable when it is caused by an or^ 
ganic disease of the brain or spinal marrow. When it arises 
from other causes, such as indigested food in the stomach, affec^ 
tions of the bowels, liver, or uterine organs, a cure may be 
effected. 

I knew an instance of a man in Baltimore who was cured of 
epilepsy by a single course of medicine. He had been subject 
to occasional attacks of the disease for about two years previous 
to his taking the course of medicine. 

Exercise in the open air, a well regulated diet, cold shower 
bathintlie morning, frictions of tlie surface, and tonics medicines 
will be proper means of invigorating the system. 



2 C 



IIHH 



SECTION IT. 



INFANTILE CONVULSIONS, 

Convulsions frequently occur in childhood, and more espe- 
cially in infancy. During this tender period, the functions of 
the brain are liable to become disordered, or suspended, from 
various causes. In some large families of children, the predis- 
position to convulsions is so strong that every one of them will 
have fits during the period of teething. In other families this 
form of disease is very rare, although the gums may be equally 
irritated and painful, and the digestion even more impaired. 

Cftitses.— Indigested food in the stomach, irritation of the 
gums from teething, or worms in the stomach and bowels, are 
the general causes of convulsions in infants and children. 

The use of anodynes, laudanum, and various other prepara- 
tions containing opium, predispose infants to convulsions by 
their tendency to produce congestion of blood on the brain. The 
following circumstance was related to me by a lady, intimately 
acquainted with the family in which the melancholy affair hap- 
pened. A nurse wishing to visit a friend, gave an infant a dose 
of laudanum, that it might not need attention in her absence. 
Soon after it was given, the cliild was seized with convulsions, 
which continued to return at frequent intervals, requiring con- 
stant watching day and night up to the time when this statement 
was made to me, being a period of two years. The faculties of 
the mind were destroyed by the fits, with scarcely the possibility 
of remaining for life other than an idiot. 

Thousands of children have their intellectual powers injured 
by being forced to swallow anodynes. Laudanum occasions 
sleep by producing partial congestion of the blood in the brain; 
and it eases pain by benumbing the sensibility of the nervous 
system. 

Children are peculiarly liable to convulsions during the early 
stages of eruptive disease,— small-pox, measles, and scarlet fe- 
ver. More especially are they apt to occur a sliort time previ- 
ous to the eruption. On the event of the eruption striking in, 
convulsions are very frequently observed. In very young in- 
fants, the cold stage of << fever and ague" is sometimes accompa- 
nied by convulsions. 



INFANTILE CONVUI SIGNS. 219 

In children, as well as in adults, the cause of convulsions is 
sometimes seated originally in the hrain or spinal marrow, ren- 
dering medical means unavailing. 

Fatalitij. — Death from convulsions, though of very rare oc- 
currence in adults, in infants and children is by no means un- 
common. *^In ordinary constitutions there is but little to be 
apprehended from convulsions during infancy, when the attacks 
are slight and of short duration; and this observation applies 
especially to those instances which, instead of leaving the infant 
in a dull lethargic condition, are almost immediately succeeded 
hy the natural cheerfulness of the child.'* 

Unfavourable Symptoms. — When the convulsions are of long 
continuance, attended with a dark, or purple appearance of the 
countenance, palsy of one side, or of a limb, squinting, and diffi- 
cult and sterterous breathing, the symptoms may be considered 
unfavourable. 

Treatment — Infantile convulsions are caused in the great ma- 
jority of instances by constitutional disorder, the seat of which 
is in the stomach and bowels, and require for their cure that kind 
of treatment which is proper to cleanse the stomach and bowels, 
and restore their natural functions, and also to equalize the cir- 
culation of the blood and nervous fluid. 

The first symptoms usually observed in convulsions are, a 
spasmodic contraction of the muscles of the chest and throat from 
loss of nervous power in these parts : the breathing is almost 
suspended, and congestion of blood on the brain ensues, followed 
by convulsions. 

Jlnti-Spasmodics are especially indicated in the treatment of 
convulsions, of which the third preparation of lobelia is the best 
probably that can be used. I have never heard of an instance 
of a child being suffocated by stimulating medicine, but I know 
of two instances in which death was occasioned by the use of 
castor oil. When stimulating medicine reaches the tliroat, in- 
stantly the windpipe is closed against its passage, and thus the 
medicine is conducted to the right passage to be carried into 
the stomacli, notwithstanding the unconsciousness of the patient. 
When the sensibility is very low, a substance like castor oil 
might glide into the wind-pipe instead of the proper passage, 
and in this way occasion suffocation. It is only during the pa- 
roxysms that I would think of giving the third preparation of 
lobelia aloue to a child, but I often give it in this way during 
convulsions. 



220 CHLOROSIS. 

The third preparation of lobelia, not only is the best anti-spas- 
modic, but it is also the most efficient emetic, containing suffi- 
cient stimulous to enable the stomach to act promptly. It may 
be given alone or combined with luke-warm water, bayberry tea, 
or added to about twice its quantity of boiled milk. 

In the absence of the third preparation, lobelia may be given in 
the form of tea, made by adding warm water to the lobelia 
powder; or the powder mixed with an equal quantity of No. 
6, and given in bayberry or composition tea. 

A stimulating injection must be administered as soon as prac- 
ticable, and repeated as often as the circumstances of the case 
demand it. 

Wlien the convulsions subside, the use of lobelia sliould be con- 
tinued with the view to prevent a return oi the paroxysms, un- 
less the patient have previously vomited freely. 

The use of injections is particularly indicated on account of their 
tendency to attract the circulation to the bowels, and thereby 
lessen the pressure of blood upon the brain. If the patient remain 
in a state of stupour after the paroxysm, stimulating injections 
should be administered and the feet placed in warm water, a por- 
tion of mustard or capsicum added to it; or a vapour bath ad- 
ministered, the child being held in the parent's or nurses' lap. 

If the head be hot, cloths wet with cold water or vinegar 
must be applied. 

When the gums are swollen and irritated benefit may be de- 
rived by cutting them down to the teeth. 

Frictions and stimulating embrocations along the course of 
the spine will be found useful. 



SECTION v« 



CHLOROSIS.— GREEN SICKNESS. 

The term chlorosis is applied to a form of disease in wbicis 
there is marked paleness of tlie skin, absence of the natural red 
colour of the lips, swelling of the eye-lids, a soft and flabby state 
of the skin, loss of flesh, general coldness of tlie system, a ten- 
dency to a swelling of tlic feet and ankles, loss of a])petite, and 



CHLOROSIS. 221 

torpor of the bowels. The tongue is pale, swollen, and more or 
less furred. Menstruation is deficient, and sometimes this evac- 
iiation is entirely suppressed. There is frequently a craving for 
pickles, chalk, or cinders. 

As the disease becomes more deephj seated, the countenance is 
still more palid, and sometimes assumes a yellow or greenish 
appearance. ** Tiie skin is smooth, but is preternaturally dry. 
The tendency to dropsical swellings of the feet and ankles in- 
crease, but there is seldom any further wasting of the flesh. 
*'The tongue clears and becomes smooth, but continues pale, 
with a slight but peculiar appearance of transparency, and has 
a lilac hue. The patient is affected with languor, lassitude and 
even serious weakness, being at once reluctant and unable to un- 
dergo fatigue." There are often severe attacks of pain in the 
side and head, palpitation of the heart, faintness and a sensation 
of suffocation. The bowels are inactive, with occasional attacks 
of diarrhoea; the stools are dark, foetid and scanty. The diges- 
tion is always greatly impaired, yet patients will sometimes have 
a craving appetite for food, as well as for indigestible substances, 
such as tea-leaves, coffee grounds, morter from old walls, chalk, 
pickles, or charcoal, 6cc. 

There is a peculiar tendency in this disease to a bleeding from 
the nose, stomach and bowels, or uterus. The blood discharged 
is pale and watery, sometimes scarcely producing a stain on 
linen. 

An attack of chlorosis though not free from danger, is generally 
curable by judicious treatment early applied, before the disease 
assumes an inveterate character. 

Ill chlorosis the amount of heat generated in the system is 
much less than is produced in a state of health; every organ in the 
body is in a torpid condition; the secretions are diminished, but 
little bile is formed; the mucous membrane of the stomach and 
bowels is coated witli thicker secretions forming a false mem- 
brane; digestion, assimulation and nutrition, are imperfectly 
performed; and the blood is in a weak and impoverished condi- 
tion. 

Treatment. — The general course of treatment indicated for 
the cure of the above form of disease is as follows: 

1st. To warm the system by the use of jmre stimulants and 
external warmth. 

2d. Courses of medicine,— To be administered as the circum- 
stances of the case may demand. 



222 CHLOROSIS. 

3d. Injections to evacuate and tone the bowels, and also to act 
upon the uterine functions, through nervous influence. 

4th. The continued use of pure stimulants and the strongest 
kinds of bitters or tonics. Gentle exercise, fresh air, and a 
light nourishing diet are important curative means in the treat- 
ment. 

Course of Medicine. — There is no plan of treatment that can 
fulfil so many important indications for the cure of this disease 
as a course of medicine. Under its influence a new action is 
awakened throughout the whole system. The steam imparts 
warmth to the blood, equalizes its circulation, strengthens the 
nervous energy, increases the sensibility of the stomach to the 
impression of medicine, and for a time restores the functions of 
the skin, by which morbific matter is thrown off" from the blo6d. 
The chest expands more freely, affording a greater supply of air 
to the lungs, thereby augmenting the vitality of the blood. By 
the emetic the stomach is relieved of matter which had oppressed 
its functions; the efforts to vomit whilst the system is relaxed 
tends to remove obstruction in the liver and in other important 
organs. The stimulus of the medicine augments the secretions 
and occasions a determination to the surface. Injections relieve 
the bowels, and through the medium of the nerves exert a benefi- 
cial influence upon the uterine organs, the functions of which 
are always deranged in chlorosis. Lastly, but not least in im- 
Ijortance, under the operation of the course of medicine, more 
or less of the false coating or *• canker" becomes detatched and 
removed from the coats of the stomach and bowels. This false 
membrane must he removed before the general health can be restored, 
I have known, on several occasions, quarts of a skinny-like 
substance discharged by the bowels in cases of chlorosis, which 
probably had been formed in the early period of the disease. 

Eepeating the Course. — As a general rule the course of medi- 
cine will require to be administered most frequently in the ear- 
lier period of the disease. When the disease has become deeply 
seated, and the system cold, torpid, and much weakened, it may 
not be necessary to repeat a course oftener than once in two or 
three weeks. 

Preparing the Emetic. — In all cases where there is great want 
of tone in the stomach, and a general torpor throughout the sys- 
tem, the liquid of the third preparation of lobelia is the most ef- 
fectual emetic. It should be given in a very strong tea of bay- 
berry or sumac. 

Milk porridge, or gruel seasoned witlj salt and pepper, must 
be given both during and after tlie operation of the emetic. 



CHLOROSIS. 223 

Injections are necessary, not only to stimulate the bowels to 
action, but when properly prepared, they exert an influence over 
the functions of the uterine organs. Hence, during the men- 
strual period, or at the time that this evacuation is looked for, 
an enema composed of bayberry tea, adding a teaspoonful of the 
third preparation of lobelia; or of composition tea, adding a tea- 
spoonful of lobelia powder, should be administered two or three 
times a day. Tlie patient to be kept warm in bed, with warm 
bricks to the feet, and abdomen, or back, and an occasional 
dose of composition, capsicum, or spice bitters administered. 
The vapour bath should be omitted during the menstruation, un- 
less the discharge should continue too long, and become very 
profuse. In chlorosis the stomach is colder than natural, re- 
quiring the assistance of stimulants and tonics, in order to facil- 
itate digestion. The time for taking the stimulants, more espe- 
cially pepper, is at meals; and tonics immediately before or 
after. 

The Compound Lohelia Pills may be used as a general medi- 
cine in all cases of chlorosis. Ten or twelve of these pills may 
be taken daily, and they furnish a moderate and permanent 
stimulus to the stomach and bowels, and exert a beneficial in- 
fluence in correcting their secretions. When liquids oppress 
the stomach, or the patient prefers medicine in the form of pills 
to decoctions, tonics as well as the stimulants may be given in 
this form — such as quinine pills, and pills composed of bitter 
extracts. 

Gum myrrli is a useful tonic in Chlorosis. It may be formed 
into pills, and three or four taken after each meal, or the myrrh 
may be finely pulverized, mixed with quinine or bitter extracts, 
and the compound formed into pills. 

White mustard seed or prepared charcoal muy be used to 
aid in stimulating the bowels to action. 

The Diet must be light and nourishing, not to be confined 
however, to vegetables. Wild game, fresh beef and mutton, 
eggs, and whatever is found to agree with the stomach. Pastry 
and hot bread of every description must be avoided. 



SErCTTlON Vr.^ 



HYSTERIA— HYSTERIC FITS. 

Hysteria presents in different cases a great diversity of 
symptoms. It mostly occurs in paroxysms. 

Symptoms — ^At one time "the fit consists of excessive lauglitei* 
alternating with crying or screaming; and at another with men- 
tal alienation, rapid and incoherent talking, singing, suffocating 
spasms in the tliroat, a wild and furious expression of counte-* 
nance, raving, gnashing the teeth, tearing out the hair, beating 
the breast with the hands, biting, &c. Occasionally these symp- 
toms subside without terminating in convulsions. More com- 
monly, however, convulsions of a terrific character speedily en- 
sue." During the spasms ^Hhe body is usually ridgidly bent 
backwards, or variously and most powerfully contorted; the 
breast is projected forward, and the head drawn backwards; 
the face is swollen; the tongue protruded, or the jaws firmly 
closed; the eyes rolling, prominent, aiul red; the teeth gnash; 
the fists are clenched; the arms spasmodically thrown about^ 
and the abdominal muscles powerfully contracted; in short, the 
whole muscular system is thrown into such violent spasms that 
scarcely any effort of the by-standers is sufficient to restrain the 
contortions, or prevent the patient from being thrown out of 
bed." 

** When the paroxysm ceases, the patient is left in an exhausted 
or stupid and somnolent condition, which in the course of ati 
hour or two passes away without leaving any other affections 
than a feeling of general soreness, and a slight pain in the head 
and pit of the stomach." 

Sometimes instead of spasms, stupor and insensibility ensue, 
the limbs are in a relaxed condition, the jaws firmly closed, the 
eyes shut, the countenance nearly natural, the breathing irregu- 
lar, the pulse slow and regular, the extremities are cold, and the 
power of swallowing is lost. Young females sometimes remain 
in this condition many hours, or even the whole day or night. 

Causes.— Indigested food in the stomach; sedentary habits; 
suppressed or difficult menstruation; damp and cold feet; and 
violent mental emotions — excessive joy or grief— are causes of 
hysteria* 



HYSTERIA. 225 

Hysteria never occurs in childhood, it being almost exclusive- 
ly confined to the period wliich intervenes between the fourteenth 
and fiftieth years. It is almost peculiar to females, still the 
disease, in a mild form, sometimes happens to men, more espe- 
cially to those who lead a sedentary life, and are of a delicate 
and nervous temperament. 

Patients subject to hysteric fits, are apt to feel a tenderness in 
some part of the spine when it is pressed upon, which fact has 
led some physicians to view hysteria as a disease depending up- 
on irritation of the spinal marrow. Other theorists contend 
that its seat is in the uterus, whilst others again locate the dis- 
ease in the brain. It would be useless in a practical point of 
view, to attempt to sustain or refute any of tliese theories, as the 
disease, in all cases, must be treated upon general principles, ap- 
plying the remedies to suit the emei^gency of the case. 

Treatment. — Hysteric fits are generally preceded by extreme 
languor, coldness of the hands and feet, and distress at the pit 
of the stomach. At this period stimulants should be given, — 
capsicum, composition, or spice bitters. No. 6, essence of pep- 
permint, or lavender brandy, may be also used to expel wind 
from the stomach. The feet should be placed in warm water, 
and volatile salts applied to the nose. 

If the symptoms be not relieved by the above means an emetic 
must be given, and the patient warmly covered, and warm bricks 
applied to the feet. 

The Vapour Bath Warm vapour applied to the surface 

soothes nervous agitation, and is signally beneficial in all cases 
of hysteric affections. When the system is very cold, the bath 
preceding an emetic will materially assist the operation of the 
latter. 

Injections. — Stimulating enemas are scarcely less important, 
both as a preventive and curative means, in hysteria. The 
liquid of the third preparation of lobelia, or the lobelia powder 
in No. 6, is to be administered in warm water, bayberry, com- 
position, or skull-cap tea. W^hen there is a violent determina- 
tion of blood to the head, the use of stimulating enemas are 
particularly called for, as they prove an efficient means of equal- 
izing the circulation of the blood, and of sustaining and equal- 
izing the nervous influence. Mustard plasters applied to the 
feet, ancles, and wrists, may have a beneficial influence in sooth- 
ing nervous agitations. 

Jlntispasmodics. — The third preparation of lobelia is the best 
antispasmodic, and it also answers as an emetic and stimulants 

2D 



wmmmmm 



HTSTERIA. 

This medicine may be given in teaspoonful doses at any time 
when the patient can swallow. Even during hysteric convul- 
sions, the liquid of the third preparation poured into the sides of 
the mouth when the teeth are firmly closed, will have an influ^ 
ence in shortening the paroxysm, even though the medicine 
should not be swallowed. 

Musk may be employed with benefit in hysterical paroxysms. 
The high price of the article, however, together with the circum- 
stance of its being rarely found in the shops free from adultera- 
tion, has occasioned the almost entire abandonment of its use m 
practice. 

Castor. — This is a stimulant and antispasmodic, and may be 
used in hysteria. The dose is from ten to twenty grains, given in 
a bolus, or rubbed up with elm powder, and then sufficient water 
added to make it easy to swallow. 

When violent paroxysms of hysteria take place in consequence 
of a sudden check to the flow of the menses, stimulating enemas 
to the bowels must be administered, in addition to the general 
treatment above mentioned. A tablespoonful of the third pre- 
paration of lobelia may be administered at one time, in severe 
cases; or two teaspoonsful of spirits of turpentine, rubbed with 
a little dry elm powder, or beat up with the white of an egg, 
adding a teaspoonful of the third preparation of lobelia, and half 
a pint of warm water, or simple herb tea. The enemas are to 
be repeated until the desired effect be produced. 

Warm fomentations are useful to relieve pain in the chest or 
abdomen. If the head be hot, cloths wet with cold water, spi- 
rits or vinegar, may be applied, and changed frequently. 

*<In that variety of paroxysmal hysteria,'' says Dr. Eberle, 
"in which the patient lies in a state of torpor and insensibility 
distinct from syncope, I know of no remedy so effectual for dis- 
pelling the attack as an emetic." If the patient cannot be made 
to swallow, lobelia administered to the bowels in full doses and 
retained, will have the same effect upon the system as when 
taken into the stomach. A mustard ])laster, or pepper poultice 
applied to the pit of the stomach, will aid in exciting vomiting. 
\Vhen mustard is employed it should be removed before it blis- 
ters the skin. 

During violent paroxysms of hysteria it will be useless in 
many instances, to attempt to administer medicine until the 
spasms subside. As soon as the spasms give way, and the pa- 
tient can swallow, an emetic should be given with a view to pre- 
vent the return of the convulsions. The best form of emetic in 
all such cases is, a large teaspoonful of the liquid of the third 



HYSTERIA. 227 

preparation of lobelia, with about an equal quantity of lobelia 
powder, mixed in a teacup two-thirds full of bayberry or sumac 
tea. The emetic is to be repeated until vomiting be effected. 
Acids in the stomach interfere with the operation of emetics, and 
whenever the emetic is slow in its operation, a teaspoonful of the 
bi-carbonate of soda, or half the quantity of salseratus should be 
given, dissolved in a teacupful of lukewarm water. 

Chronic Hysteria. — Unmarried females whose digestive pow- 
ers are greatly impaired, who are of a weak liabit of body, and 
possess an easily excited temperament, and more especially those 
who are subject to profuse or too frequent menstrual evacuations, 
are peculiarly liable to hysteric symptoms. " They are always 
complaining of some unpleasant or painful sensations; their tem- 
per is variable, often fretful, sometimes animated, talkative, and 
anon peevish and gloomy; they pass often rapidly from laughing 
to crying, from gaiety to melancholy, from despondency to hope, 
and vice versa, from the most trifling causes. They often com- 
plain of various distressing sensations in the abdomen, head, and 
chest, flatulency, a rumbling noise in the bowels, severe colic 
pains, a sense of weight and bearing down in the region of the 
uterus, pain in the neck of the bladder, dysury, a feeling of 
emptiness or fullness and tension at the pit of the stomach, vari- 
able appetite, slow digestion, eructations, occasional spells of 
great anxiety and alarm, palpitation of the heart, '^ faintness, 
a peculiar sensation of weight, or of numbness in the top of the 
head, severe pains in the head, breast, or other parts of the body, 
and sometimes the sensation of a ball rising in the throat. 

Treatment of Chronic Hysteria, — Hysteric symptoms that have 
been of long continuance, can be cured only by restoring the 
general health of the patient. To accomplish this, an occasional 
emetic, or course of medicine, stimulants and tonics, are the reme- 
dies chiefly to be employed. 

Dr. Dean, of Harrisburg, (Pa.) observes, ^'in some cases 
where the patients had laboured under this disease for ten years, 
and during that time had, by the advice and directions of respec- 
table physicians, exhausted, with at most, but temporary bene- 
fit, the whole class of remedies which are usually prescribed, I 
have, by the continued exhibition of vomits, either entirely re- 
moved the complaint or so far removed the habits of diseased ac- 
tion in the stomach, that anti-spasmodic and tonic medicines 
would in general complete the cure." (Eberle.) The proper 
time for giving an emetic or a course of medicine is when the 
patient feels more distress than usual. 

Tonics, — Gum mtjrrh is a useful tonic in hysteric complaints, 



228 HYSTERIA. 

when the disease is associated with an excessive flow of the men- 
ses. The myrrh should be finely pulverized, and formed into 
pills, three or four of which may be taken after meals; or a de- 
coction made of it by steeping it in boiling water. 

Other tonics, such as columbo, gentian, balmony, unicorn 
root, barbary, Virginia snake root, and prickly ash, may be 
employed either simply or in combination. 

When the patient has a craving for some particular substance, 
such as acids, chalk, or charcoal, they should be used unless 
they are found to disagree with the stomach. 

I have in several instances known patients to eat freely of 
bread and butter dipped in vinegar, which agreed with the sto- 
mach. 

Charcoal is decidedly beneficial where the bowels are habitu- 
ally constipated, or when the patient ih harassed with sour eruc- 
tations or heartburn- 

When the bowels are habitually costive, to use injections of a 
decoction of aspen poplar and bayberry bark at bed time, and 
retain them until morning, will relieve the bowels and at the same 
time increase their strength and tone. Purgative medicines must 
be avoided, for notwithstanding they may afford momentary re- 
lief, yet eventually the functions of the bowels will be always 
weakened by them. By a proper course of constitutional treat- 
ment, joined with a well regulated diet and regimen, and an 
abandonment of cathartic medicine, the functions of the bowels 
will become restored, unless there be an organic derangement, 
stricture of the rectum, for instance. I have in repeated in- 
stances been surprised to find the bowels recover their function 
so as to be moved naturally in so short a period under such a 
course of treatment as above alluded to. Yet w here patients 
have been liabitually costive for many years, and the bowels sel- 
dom moved iniless provoked by a cathartic, the free use of char- 
coal and bitters, stimulating injections to move the bowels, to- 
getlier with the injection at bed time, as before mentioned, the 
use of bread made of unbolted flour, or gruel made of the same 
material, besides other articles of food that are nourishing and 
easy of digestion, will generally prove successful in restoring 
the natural action of the bowels in the course of a few weeks. 
Injections composed of salt and molasses, each a tablespoonful, 
adding a pint of hike-warm water, and a teaspoonful of green 
lobelia powder, will sometimes succeed in procuring a passage 
from the bowels when the usual stimulating injections have 
failed. 



SECTION VII. 



FAINTING. 



A deficiency of arterial blood in the brain is the usual cause 
of fainting. Thus persons bled whilst sitting up will faint much 
sooner than when lying with the head on a level with the body. 
Persons who are very weak, sometimes faint from sitting up 
when confined by sickness. Some faint at the sight of blood; 
others from sudden frigiit or from any other violent mental emo- 
tion. 

Symptoms. — These are, sudden loss of sensibility, and of the 
power of motion; the breathing and pulse scarcely perceptible, 
or entirely suspended, and the countenance and lips pale and 
bloodless. 

Treatment. — The immediate cause of fainting being a defi- 
ciency of arterial blood in the brain, the most important indica- 
tion for recovering the patient is to place the head as low or 
lower than the level of the body, with a view to favour a supply 
of blood to the brain. Cold water may be sprinkled or dashed 
on the face; all tight dresses loosened; and salts of hartshorne, 
caiogne or camphor applied to the nose. 

If fainting occur in a close room or crowded assembly, the 
patient must be taken into the open air, and if the weather be 
very warm, fanning will be of advantage. A person fainting in 
an assembly is very apt to be so closely surrounded by the by- 
standers, as to intercept the circulation of air around the patient. 
Tliis should be prevented on all occasions where a patient has 
fainted. 

I have known patients to faint from setting up to take a va- 
pour bath. When they first begin to feel faint, a dash of cold 
water in the face, holding the head downward for a few moments; 
for instance resting the head low on a chair, and applying some 
volatile stimulant to the nose, usually revive the patient and 
enable him to continue in the bath the usual time required in 
steaming. If the tendency to faint should continue, the patient 
must be placed in bed. 



SECTION Till. 



HYPOCHONDRIASIS. 
(dejection oe mind— xow spirits.) 



This iinliappy and ill-forboding state of mind, is principally 
confined to persons in advanced life, and it is always associated 
with feeble digestion. There is distress at the pit of the sto- 
mach; flatulency and acid eructations; extreme coldness of the 
hands and feet; torpid bowels; and either a dry, or cold and clam- 
my state of the skin. Very frequently the countenance is sal- 
low, indicating a torpid state of the liver. 

Characteristic Symptovis. — ^^ A disposition to seriousness, sad- 
ness and timidity as to all future events; an apprehension of the 
worst and most unhappy state of them, and therefore, on slight 
ground, a dread of approaching evil." The patient thinks and 
talks about his unliappy condition, and observes every change 
of feeling in his body with apprehensions of danger. In some 
instances the nervous system will be shocked with the most tri- 
fling noise, causing the patient to startle even at the dropping of 
a knife at the table, and occasion a very unhappy state of mind, 
sometimes exciting a revengeful feeling, even against their off"- 
spring. I have known patients labouring under this distressing 
weakness to be unable to bear the slightest noise from the play- 
ing of their own children, requiring them to be kept out of sight 
and hearing. In other instances the mind sinks into a kind of 
sullen gloom, with constant forebodings of coming evil. 

Causes. — The immediate cause of this dejected state of mind, 
technically called, "hypochrondriasis," is exhaustion of nervous 
power. Severe mental labour, indolent habits, inveterate dys- 
pepsia, domestic trouble, debauchery, the excessive use of to- 
bacco, or the long continued use of opium, are, in many in- 
stances, the remote cause of that dejected state of mind conse- 
quent upon a torpid and enfeebled condition of nervous energy. 

The habit of viewing the dark-side, only, of events, and yield- 
ing the imagination to gloomy forebodings, exerts a depressing 
influence upon the brain — weakens the energies, and consequent- 



HYPOCHONDRIASIS. 231 

ly impairs the powers of digestion, and thus may be laid a foiiii- 
datiou for continued despondency. 

The advice contained in the following lines may be found ap- 
propos to those of a desponding disposition. 

<* J\*ever look sad — nothing so bad 

Js getting familiar with sorrow; 
Treat him to-day in a cavalier way, 

Jind he'll seek other quarters to-morrow,^^ 

** Long you^d not weep, would tjou but peep 
M the RBiGHT SIDE of everij trial; 

Fortune youHlJind, is oft most kind. 
When chilling your hopes with denial.'^ 

" Let each sad day, carry awaij 

Its own heavy burden of sorrow; 
Or 'tis likely youHl miss, half of the bliss 

That comes in the lap of to-morrow.'' 

'' When hope is wreck' d, pause and reflect 

If error occasioned your sadness; 
If it be so, hereafter you'll know. 

How to steer to the harbour of gladness.'^ 

Patients advanced in years, however, whose nervous energy 
is greatly exhausted, have not the power to prevent despondency 
of mind, auy more than they can prevent a fit of ague at will. — 
The general health must be improA^ed, and the nervous influence 
aroused from its torpid state before the mind can be raised from 
its sunken, dejected condition. 

Treatment. — When depression of mind is caused by a disor- 
dered state of the system, the most effectual medical remedies 
are, courses of medicine administered at proper intervals, to- 
gether with the use of composition, or cayenne and bayberry^ 
followed by the use of bitters. 

A course of medicine, by cleansing the stomach, and awakening 
a new action in the system, will frequently be attended with the 
most happy effects upon the mind. In deeply seated cases, how- 
ever, the course of medicine will have to be repeated occasional- 
ly for a period of several months, before the general health can 
be thoroughly restored. 

Capsicum is the best stimulant, and should be taken at meals 



232 HrPOCHONDSIASIS. 

or soon after eating: the powder may be taken in luke-warm or 
cold water, or it can be taken in the form of pills. 

The compound lobelia pills answer as a stimulant, and they will 
act efficiently on the secretions, both of the skin and mucous 
membrane of the stomach and bowels. I attended a patient 
whose mind was greatly depressed from ill health, who took from 
forty to fifty of the compound lobelia pills daily, besides three or 
four teaspoonsfui of capsicum, without making any sensible im- 
pression on the stomach and bow^els. After taking several 
courses of medicine, and continuing the use of the stimulants 
above mentioned, a skinny substance began to pass from his 
bowxls, and continued to pass from them for weeks. At the 
time this skinny substance was passing, the patient experienced 
frequent griping pains in the bowels, a symptom which is com- 
plained of under the use of Thomsonian remedies in seated dis- 
eases. The above treatment, together with the use of bitters, 
exercise in the open air, and a light nourishing diet, succeeded 
in restoring the general health of the patient, and raised his spi- 
rits from a state of extreme depression and melancholy. 

During the summer of 1837, when Brandreth's pills had 
come into general use through the influence of ingenious adver- 
tisements, circulated through the medium of newspapers, one of 
Brandreth's agents called at my office for advice. He was la- 
bouring under great depression of mind, being scarcely capable 
of overseering the business of a small shop, of which he had the 
charge. He had taken his own pills until they had destroyed the 
tone of his stomach and bowels, occasioning the dejection of 
spirits under which he had four months been labouring. I pre- 
scribed composition powder to be taken in luke-warm water four 
times a day. After this remedy had been continued two or three 
days, a full course of medicine was administered, which together 
wdth the subsequent use of tonics, effiictually restored his system, 
and consequently his mind to a healthy condition. 

There are cases of low spirits in which moral hifluences are of 
more importance in the cure than medical treatment. In two in- 
stances I have known despondency and extreme dejection of 
spirits to be occasioned by a retirement from business. In one 
of these cases, the patient took several courses of medicine, but 
still the low spirits continued until he resumed business, and his 
former active habits. In the other case the gentleman also re- 
sumed his former active habits, by which the strength, both of 
body and mind, were reinstated. 

When the nervous energy becomes depressed from too close 
application of the mind to study or business, exercise in the open 
air, travelling, and cheerful society are important. 



IIirOCHIlONDRIASIS. 233 

Reading entertaining books, and every kind of innocent 
amusement should be indulged in, to divert the mind, and bring 
new objects into view, when it is not convenient for the patient 
to perform a journey. 

Various Means liave been successfully employed for the cure 
of the hypOf as it is usually called. 

The following is from the Medical Companioiiy written by 
James Ewell. 

^^ Some hypochondriacs have fancied themselves miserably 
afflicted in one way, and some in another — some liave insisted 
that they were tea-pots, and some that they were TO^YN clocks. 
This that he had a big belly, another that his legs were glass — 
one that he was extremely ill, and another that he was actually 
(lying. But I have never heard of any of this blue-devil class 
whose extravagance ever yet came up to the following, which 
was related to me by my noble hearted old friend, the late Dr. 
Stevenson, of Baltimore, whose name sounds in my ears as the 
summary of every manly virtue. 

^*This hypochondriac, who, by the bye, was a patient of Dr. 
Stevenson's, after ringing the change on every mad conceit that 
ever tormented a crazy brain, would have it at last that he was 
dead, actually dead. Dr. Stevenson having been sent for one 
morning in great haste by the wife of his patient, liastened to 
his bed side, where he found him stretched out at full length, 
his hands across his breast, his great toes in contact, his eyes 
and mouth closely shut, and his look cadaverous. 

^^ ^ Well, sir, how do you do ? how do you do this morning ?' 
asked Dr. Stevenson, in his blustering, jocular way, approach- 
ing his bed-side. *How do I do!' replied the hypochondriac 
faintly, *a pretty question to ask a dead man!' 'Dead!' re- 
plied the Doctor. * Yes sir, quite dead : I died last night 
about twelve o'clock.' 

*^ Quick as lightning Dr. Stevenson caught his cue, wliich 
was to strike him on the string of his character, on which the 
Doctor recollected he was very tender. Having gently put his 
hand on tlie forehead of the hypochondriac, as if to ascei'tain 
whether it was cold, and also having felt his pulse, he exclaimed 
in a doleful tone, * Yes, the poor man is dead enough — 'tis all 
over with him, and the sooner he can be buried the better.' Tlicn 
stepping up to his wife, and whispering her not to be frightened 
at the measures he was about to take, he called to the servant, 
^My boy, your poor master is dead, and the sooner he can be 

put under ground the better. Run to Mr. C m, for I know 

he always keeps New E'lgland coffins by him, ready made, and 
do you hear, bring a coffin of tlie lai'gcst size, for your master 

2E 



254 HYPOCHONDRIASIS. 

makes a stout corpse, and having died last night, and the wea- 
ther being warm, he will soon begin to smell.' 

*^Away went the servant, and soon returned with a proper 
coffin. The wife and family, having got their lesson from th© 
Doctor, gathered around him and howled no little, while they 
were putting the body in the coffin. Presently the pall-bearers, 
who were quickly provided, and let into the secret, started with 
the hypochondriac for the church-yard. They had not gone far 
before they were met by one of the towns-people, who, having 
been drilled by the facetious Stevenson, cried outj *Ah, Doctor! 
what poor soul have you got there?' 

<^ * Poor Mr. B — — ' sighed the Doctor, * left us last night.* 

" * Great pity he had not left us twenty years ago,' replied th© 
other, ' for he was a bad man.' 

** Presently another of the towns-men met them with the same 
question, * And what poor soul have you got there. Doctor?' 

'**Poor Mr. B ,' answered the Doctor again, *is dead.' 

** < Ah, indeed!' said the other, ^ and so the devil has got his 
own at last.*" 

*** Oh, villain !' exclaimed the man in the coffin, *if I was not 
deadf how I would pay you for that.' 

** Soon after this, while the pall-bearers were resting them^ 
selves near the church-yard, another one stepped up with the 
old question again : * what poor soul have you got there, Doctor?^ 

" * Poor Mr. B- — -,' he replied, *is gone.' 

** * Yes, and to h — 11,' said the other, *for if he has not gone 
there, I see not what use there is in such a place.' 

"Here the dead man, bursting off the lid of the coffin, which 
had been purposely left loose, leaped out, exclaiming, * Oh, you 
villain! I am gone to h — 11, am I! — well I have come back again 
to pay such ungrateful scoundrels as you are.' A race was im- 
mediately commenced between the dead man and the living, to 
the petrifying consternation of many of the spectators, at sight of 
a corpse bursting from the coffin, and in all the horror of a wind- 
ing sheet, racing through the street. After having exercised 
himself into a perspiration by this fantastic chase, the hypochon- 
driac was brought home by Dr. Stevenson, freed of all his com- 
plaints. And by strengthening food, generous wine, cheerful 
company, and moderate exercise, was soon restored to perfect 
Jiealth." 

The disordered state of mind exhibited in the above case, 
doubtless was occasioned by a torpid circulation of blood through 
the brain, and from extreme deficiency of nervous energy. 
Whether any other means than those resorted to by Dr. Steven- 
son could have succeeded in arousing an action in the system 
sufficient to cure the disordered imagination of the patient is a 
question not readily answered. 



S35 

^^ A certain hypochondriac, who for a long time fancied him- 
self dying of a liver complaint, was advised by Dr. Crawford, 
of Boston, to make a journey to the state of Ohio. After an 
excursion of three months, he returned home, apparently in good 
health; but upon receiving intelligence of the death of a twin 
brother who had actually died of a schirrus liver, he immedi- 
ately took tiie staggers, and falling down, roared out that he was 
dead, and had, as lie always expected, di«d of a liver complaint. 
Dr. Crawford being sent for, immediately attended, and asked 
the hypochondriac how he could be dead, seeing he could talk. 
But still he would have it that he was actually dead. Where- 
upon the sagacious Doctor exclaimed, * Oh yes, he is certainly 
dead, and it is more than probable his liver was the death of him. 
However, to ascertain the fact, I will hasten to cut him open 
before putrefaction takes place.' And thereupon, getting a carv- 
ing knife, and w betting it as a butcher w^ould to open a dead calf, 
he stepped up to him and began to open his waistcoat, when the 
hypochondriac, horribly frightened, leaped up with the agility 
of a rabbit, and crying out, 'Murder! Murder!!' ran off with a 
speed that w^ould have defied a score of doctors to catch him. 
After running a considerable distance, until he was almost ex- 
liausted, he halted; and not finding the doctor at his heels, soon 
became composed. From that period this gentleman was never 
known to complain of his liver; nor had he for moretlian twenty 
years afterward, any symptoms of this lYisesLSc^'-^EweWs Med- 
ical Companion, 



SECTIOX IX. 



ST. VITUS' DANCE. 



Symptoms — It commences w4th twitching or jerking of the 
¥nuscles of some portion of the body, generally first observed in 
the face or in one of the limbs. These sudden contractions of 
the muscles are usually slight at first, occurring only occasion- 
ally, and more particularly when the mind is grieved or agitated. 
By degrees these jerking motions increase, until, in many in- 
stances, almost every muscle in the body is affected with spas- 
modic contractions. In many instances the contractions are 
much stronger on one side of the body, and frequently they ai-e 
confined almost exclusively to the left side. ** From the imper- 
fect command of the will over the voluntary muscles, the patients 



236 

when lie attempts to walk, lias a starting, hobbling, and irregu- 
lar gait, with an awkward dragging of one of the legs." Some- 
times the arms and legs are thrown into such confused motions, 
that the patient will be unable to walk, or even to stand alone. 
He is often unable to direct his hand to his mouth, requiring to 
be fed by another person. 

"At iirst the expression of the countenance, in the intervals 
of the spasmodic motion, is that of good humour and content- 
ment.'' In a later period of the disease, however, the counte- 
nance loses its expression of cheerfulness, the temper is irritable, 
and sometimes the intellect is enfeebled. ^^ Slight paralysis oc- 
casionally occurs on one side of the body." 

When the patient sleeps, the jerking motion of the muscles is 
entirely suspended. 

Patients aifected with St. Vitus' Dance are generally worse 
at a particular time of the day. 

The appetite is variable; sometimes voracious — at others fee- 
ble. The tongue is slightly coated, and generally somewhat 
contracted. Digestion is more or less impaired; the bowels are 
usually inactive, and the stools seldom have a healthy appear- 
ance. 

St. Yitus' dance is usually confined to the period of life which 
intervenes from the eighth to the twentieth year. 

(7a?tses.— Constitutional disorder, more especially a deranged 
condition of the digestive organs, is the chief cause of St. Vitus' 
dance. Among the occasional causes of this disease are, violent 
mental emotions; sudden fright, or anger; " repelled cutaneous 
eruptions;" suppression of the menses; and exposure to cold and 
damp. 

JSTot Dangerons. — St. Vitus' dance very rarely proves fatal. 
The few instances that have been known to terminate fatally, 
with ^^slow irritative Je-ver"- have probably been experimented 
upon by medicines which have poisoned the stomach, and des- 
troyed the vital principle. 

Duration.— In some instances this disease continues only a few 
days; in otliers it is prolonged to many months, or even years. 
When the disease is wholly dependent upon a disordered condi- 
lion of tlie stomach and bowels, it is more readily cured tlian 
when it has been brought on by sudden alarm or other violent 
emotions of the mind. Girls attacked with St. Vitus' dance, 
about the age of thirteen or fourteen, are seldom permanently 
cured until menstruation becomes fully established. The disease 
is also apt to become protracted when associated with chronic 
derangement of the general licalth. 



ST. VITUS' DANCE. 23/ 

Treatment — The following plan of treatment I have known to 
succeed in curing several cases of St. Vitus' dance, viz : — In 
the first place, give broken doses of lobelia, sufficient to occasion 
slight nausea; a course of medicine administered occasionally; 
a shower bath every morning, sometimes preceded by a vapour 
batli; and as the tongue begins to clean, or the skin becomes pale,, 
and the system relaxed, give tonics. 

On administering Broken Doses of Lobelia. — Lobelia may be 
administered in the form of pills, tincture, or the powder mixed 
in warm water. In some cases I have found it necessary to give 
as much as a teaspoonful of brown lobelia powder at a time, and 
this frequently repeated in order to effect even slight nausea. I 
have been surprised at obsei'ving tlie slight effect produced in 
even young children, by full doses of lobelia. In the case of a 
little girl labouring under St. Vitus' dance, the brown lobelia 
powder was given in full doses, and frequently repeated w ithout 
producing tlie slightest nausea, or causing any perceptible degree 
of relaxation, until several courses of medicine had been given. 
At the end of the third week from the commencement of the treat- 
ment, the patient became much distressed and deathly sick nnder 
the influence of lobelia administei'ed after the vapour bath. She 
tossed about in every direction, and continued in this w^ay sixor 
seven hours, the system being much relaxed. After this opera- 
tion, the patient began to mend rapidly. The compound lobelia 
pills are convenient to take, and may be nsed w itli as mucli ben- 
efit, probably, as any other form of lobelia. From twelve to 
twenty pills should be taken daily, and continued as long as the 
disease remains. 

The Vapour Bath is particularly beneficial in St. Vitus' dance, 
especially when the skin is in an unhealthy condition. The bath 
may be repeated daily, or every few days, as the circumstances 
of the case may indicate. After steaming, the patient must be 
showered with cold water, rubbed dry, and the surface bathed 
with No. 6, or some stimulating linament. 

Emetics. — These may be given once a \veek, or at longer or 
shorter intervals, as the character of the symptoms may 
demand. Brown lobelia powder, infused in strong compo- 
sition tea, is a proper form of emetic to administer to children. 
Lobelia administered by injection, in warm water, and retained 
several minutes, will occasion vomiting and relax the system as 
effectually as when swallowed. I have been sent for on several 
occasions where families have become alarmed by the exti'eme 
relaxation occasioned by lobelia injections. All that is required 
is to bathe the face, breast, and hands with spirits, or vinegar 



£38 

and water. It is well, however, to give occasionally some 
stimulant, No. 6, capsicum tea, composition, or even simple herb 
teas, pennyroyal or mint, together with some light nourisliment 
— milk porridge or (fsicken tea. I never knew an instance of 
St. Vitus' (lance in which the disease did not moderate after the 
patient was fully relaxed under the influence of lobelia. I have 
on several occasions, however, given from six to eight teaspoons- 
ful of lobelia powder to patients labouring under this form of 
disease, without causing any perceptible relaxation, or effecting 
even slight sickness; and then again, at another stageof the dis- 
ease, one teaspoonful, or even half that quantity, will operate ef- 
fectually both in cleansing the stomach, and relaxing the system. 

The Cold Shower Bath is much employed in the treatment of 
St. Vitus' dance. This remedy is particularly appropriate in the 
more advanced stage of the disease, after the stomach has been 
thoroughly cleansed. Tlie proper time for administering the cold 
shower bath, is in the morning, as soon as the patient is out of 
bed. After the bath is administered, the patient must be rubbed 
dry, wrapped in a blanket, and put in bed, and remain there half 
an hour, or longer. 

Tonics, — The spice bitters may be used in any period of the 
disease. In the more advanced stages of it, stronger tonics will 
be required. Quinine, wormwood, centuary, balmony, golden 
seal, (Jr Virginia snake root. The scull-cap {Scutellaria lateri- 
Jiora) may be employed both as a tonic and nervine. It may be 
taken singly in decoction, or combined with other tonics. 

Injections*— When the bowels are very costive, injections may 
be used occasionally composed of salt, molasses, and water, ad- 
ding an even teaspoonful of green lobelia to each injection. Lo- 
belia administered by injection, and retained, will benefit the pa- 
tient as much as when taken into the stomach. When the dis- 
ease has been of long continuance, however, or the patient feeble 
and emaciated, the vomiting will be best effected by the third 
preparation of lobelia taken into the stomach, 

*Rstringentf or anti-canker medicine. — In the latter stages of 
the disease, or during any period when the tongue is coated and 
manifests a tendency to clean, a strong decoction of bayberry or 
sumac, or of the two combined, must be given as often as once a 
day. In every case of St, Vitus' dance that I have attended, 
there has been a false membrane discharged from the bowels, 
and flakes of a similar substance thrown off by vomiting, 
about the time the disease gives way. Indeed I have some- 
times been inclined to believe that a coating of thickened secre- 



239 

tions over the mucous membrane of the stomach and bowels was 
a principal cause of the disease being protracted. The fact that 
patients recover soon after such a substance is observed to pass 
from the bowels, furnishes some proof in support of this opinion. 
May it not be the presence of a false membrane lining the sto- 
mach that renders tliis organ so extremely insensible to the im- 
pression of lobelia, observable in many instances in St. Vitus' 
dance. 

The No. 3 pills will answ^er in the place of the astringent teas, 
and are much more readily taken. From three to six of these 
pills may be taken three or four times a day on an empty sto- 
mach. 

Sea Bathing has been found particularly beneficial in the cure 
of St. Titus' dance. 

The diet must be nourishing, and easy of digestion, such as 
boiled milk and toast, stale bread, crackers, fresh beef and mut- 
ton, poultry, eggs, custard, boiled rice, and all wholesome ve- 
getables. All kinds of confectionary, cakes, hot bread, and 
pastry, must be avoided. The supper should always be light. 

When St. Vitus' dance is dependent upon, or associated with, 
obstructed menstruation, the method of treatment already laid 
down will be appropriate to the cctse. Particular attention, 
however, will be necessary to keep the feet dry and warm, and 
to use frequently warm foot baths. When the period arrives 
when the patient ex])3cts to be ?/?iTC'eZ^, stimulating enemas should 
be administered to tbe bowels, composed of pennyroyal tea, ad- 
ding a teaspoonful of lobelia powder to each, or of bayberry tea, 
with the addition of a teaspoonful of the third preparation of lo- 
belia; the foot bath used daily, and the patient drink freely of 
composition or pennyroyal tea, and if the general health be much 
deranged, an emetic given. If there be much pain in the back 
or loins, the patient should be kept w^arm in bed, and bottles of 
hot water or hot bricks wrapt in damp cloths applied to the back 
and feet. 



SECTION X. 



TETANUS.--LOCKED JAW 



Causes. — Locked jaw is sometimes caused by wounds; in 
other instances it is brought on by exposure to cold, when the 
vital powers are in an enfeebled condition. Sleeping in tlie open 
air, is very commonly an exciting cause of tetanus in hot climates. 
The use of narcotic poisons may also occasion tetanus. "Wounds 
of the head, gun-shot wounds, and punctured wounds in the soles 
of the feet, and palms of the hands, are the kinds most apt to oc- 
casion locked jaw. ** Tetanus is particularly apt to follow 
wounds in which a nerve is partly divided or lacerated, without 
being completely divided.*' 

Symptoms, — This formidable disease usually comes on in a 
gradual manner. At first tliere are pain and stiffness in the back 
of the neck, slight spasms in the muscles of the throat, and dis- 
tress at the pit of the stomach. In some instances these symp- 
toms continue several days before the jaws become fixed. As the 
disease increases, the jaws become stiff and at length immovea- 
ble; great distress is felt at the pit of the stomach; the whole, or 
a part of the muscles of the body and limbs become rigidly and 
permanently contracted — the head is thrown backward, and the 
body is bent either backwards, forwards, or sidewise. Sudden 
paroxysms of pain, and retraction at the pit of the stomach oc- 
cur at frequent intervals, attended with violent spasmodic con- 
traction of the muscles. ** These paroxysms last usually but a 
few minutes — the muscles of the trunk and extremities resuming 
for a while, a comparatively relaxed state; but thoseof the jaws 
remain firmly contracted during the remissions. In the latter 
period of the disease, the spasms remit but slightly and tran- 
siently: the patient is in an almost continued rack of torture; 
the muscular contractions are general and extremely violent; 
the countenance becomes frightfully distorted; copious sweats 
break out; the pulse is quick and irregular; the respiration hur- 
ried and laborious; the voice grating and unnatural; the eyes dim 
and watery, and the jaws immovcably locked. Towards the 
fatal termination of the disease, slight delirium generally occurs. 
At til is period a severe spasm often terminates the scene." 

^^The usual mode of termination in fatal cases is by apo- 
plexy. In some instances, all the muscles become completely 
relaxed a short time before death takes place. The patient 



XOCKED JAW. 241 

seems to have emerged from his terrible malady. Every part 
of the body is in the ordinary state of relaxation. Suddenly, 
however, extreme prostration of strength ensues. He becomes 
insensible and comatose; the countenance assumes a cadaverous 
expression, and death speedily follows." 

Duration. — Locked-jaw usually terminates before the fifth or 
sixth day. Occasionally however, the disease is protracted for 
weeks. 

Favourable Stjmptoms, — The remissions between the parox- 
ysms becoming complete and of longer duration; a tingling sen- 
sation in the extremities, as if ants were crawling over the parts; 
a moist, and uniformly warm skin; an increased flow of saliva 
from the mouth; *^ and above all when the patient enjoys sleep," 
strong hopes may be entertained of an eventual recovery. 

Locked jaw occasioned by causes which operate upon the sys- 
tem generally, such as sleeping on damp ground, or sudden ex- 
posure to extreme cold, is in general less fatal than when the dis- 
ease is caused by wounds. 

Preventive means m case of Wounds. — For severe wounds, 
more especially gun-shot wounds, especial care should be ob- 
served to prevent the admission of cold or damp air to the wound. 
This will be the surest means of protecting the patient from 
locked jaw. Warm stimulating poultices must be applied to 
the parts to favour suppuration. 

When a punctured wound is received in the palm of the hand 
or sole of the foot, for instance, from a nail or pin, the wound 
should be cut open, and No. 6 or spirits of turpentine poured in, 
and this repeated several times a day, and a warm poultice ap- 
plied, with a view to occasion suppuration. Locked jaw rarely 
or never occurs from such wounds when they discharge matter. 
^*It has been observed," says Dr. Ewell, ** that the less inflam- 
mation there is in the injured part, the greater will be the lia- 
bility to tetanus. This circumstance has suggested the propri- 
ety of exciting inflammation in the wounded part by means of 
irritating applications." In almost every instance where locked 
jaw has been brought on from punctured wounds, as when a nail 
has penetrated the foot, the disease has not appeared until after 
the wound has closed, and the part free from inflammation. 

If the patient be dyspeptic, or the general health otherwise 
deranged, a course of medicine must be given, followed by the 
free use of composition or capsicum, with a view to keep a de« 
termination to the surface. <* An equable and comfortable tern- 
perature, with a simple diet, and rest, are important auxiliailQs 
in preventing this disease after wounds." 

i2F 



£42 XOCKED JAW. 

Treatment of Locked Jaw, — On the first appearance of symp- 
toms which indicate the approach of locked jaw, such as slight 
spasms in the throat, a sense of stricture and distress at the pit 
of the stomach, and stiffness in the neck and shoulders, a tho- 
rough and persevering course of treatment must be instituted. 
The means chiefly to be relied upon, are vapour baths, the third 
preparation of lobelia, and powerfully stimulating injections. 

A full course of medicine must be administered without delay; 
after which the third preparation must be continued in teaspoon- 
ful doses, in bayberry tea, repeating the dose every hour or two 
as the circumstances of the case may require. When the symp- 
toms are severe, the third preparation may be given in table- 
spoonful doses, and repeated as often as every half hour, until 
the symptoms assume a more favourable aspect, when the quan- 
tity may be lessened accordingly. 

Steaming is highly important in the treatment of locked jaw, 
and in the early stage of the disease, and when the patient can 
sit up without difficulty, the vapour bath should be administered 
two or three times a day. The patient should be dashed with 
cold water at the close of the steaming, and after being rubbed 
dry, the surface bathed with No. 6, and when the patient is in 
bed, hot bricks, or bottles of hot water, wrapped in damp cloths, 
applied to the feet* 

Injections composed of a teaspoonful, or even a tablespoonful 
of the third preparation of lobelia, in bayberry or composition 
tea, must be administered at intervals of every two or three 
hours. The strictest caution must be observed to protect the 
patient from the influence of cold air on getting out of bed, when 
he is in a perspiration. Unless the air in the room be at the 
summer temperature, the patient should continue under the bed- 
clothes. 

When there is great difficulty in swallowing, the injections 
retained several minutes, and frequently repeated, will prove 
nearly, or quite as beneficial as if the medicine were taken into 
the stomach. 

When the spasms are violent, a tablespoonful of lobelia pow- 
der may be administered occasionally by injection in lukew-arm 
water, and retained, with a view to relax the muscles. When 
the third preparation of lobelia can be retained in the bowels, it 
should be used in general^ in preference to the simple lobelia 
powder. 

Wme Whey, or wine alone, may be given in large quan- 
tities. Wine whey not only affords a stimulous, but it supplies 
the system with nourishment. The difficulty of obtaining j?ztre 
wine, more especially in the country, is the chief objection to 



LOCKED JAW. 243 

the employment of this article. Madeira and Sherry are the 
, most suitable, the latter to be preferred on account of its being 
free from acid, when pure. Quarts, and even gallons of wine 
have been used daily in cases of locked jaw, with success. If, 
however, the disease be occasioned by a gun-shot or other wound, 
attended with inflammation, and the patient have a dry tongue, 
and hot skin, wine alone will he apt to form acid in the stomach 
and aggravate the symptoms. 

Local Treatment — If the disease arise from a gun-shot wound, 
or from any injury attended with sloughing, or with symptoms 
of mortification, a poultice should be applied, prepared in the 
following manner, viz: To a pound of wheat flour, add half a 
pint of yeast, and a large tablespoonful of fine ginger, and after 
mixing them well together, set the mixture by the fire until it be- 
gins to rise, then spread and apply it. The poultice must he 
kept warm, and changed morning and evening. 

When a punctured wound is the cause of locked jaw, the wound 
should be opened with a lancet or other instrument, and every 
effort used to excite inflammation and the formation of matter, 
by pouring spirits of turpentine in the fresh wound, and apply- 
ing warm stimulating poultices, such as a mixture of slippery 
elm and cayenne pepper. If the injury be on the hand or foot, 
the part should be steamed occasionally in order to attract an 
afflux of blood to the part, and favour the formation of pus. 

Either a mustard plaster or pepper poultice must he kept ap- 
plied to the spine, extending from tlie nape of the neck eight or 
ten inches down the back. The mustard should not be allowed 
to cause a blister. 

The Diet must be nourishing and easy of digestion, such as 
wine whey, essence of beef, chicken tea, oysters, eggs, custards, 
milk porridge, 6cc, 



SECTIOX XT. 



HYDROPHOBIA. 

(bite or A MAD DOG, OR OTHER RABID AT^IMAL.) 



This terrific disease is occasioned in the human system by the 
bite of a rabid animal. The poisonous saliva from the mouth of 
the animal is conveyed by its teeth into the wound, and when 
absorbed and carried into the system, brings on hydrophobia. 

When this dreadful disease becomes firmly seated in the sys- 
tem, there is scarcely the possibility of effecting a cure by any 
medical treatment. Therefore when an individual is bitten by 
a mad animal, the most prompt measures should be used to pre- 
vent the absorption of the poison which may have been deposited 
in the wound. The most important preventive means, is cutting 
out the parts that are bitten, or burning with a red hot iron, or 
with caustic potash. 

Hydrophobia seldom occurs until three or four weeks after the 
bite is inflicted. More commonly the disease does not become 
developed until the sixth or seventh week after the insertion of 
the poison. ^*It is said that the disease comes on much earlier 
in hot climates than in temperate latitudes." The disease how- 
ever, may generally, if not always be prevented by cutting out 
the parts bitten, or by cauterizing it with a red hot iron, down 
deeper than the wound itself. 

When persons are bitten through their clothes, the poisonous 
saliva will in general be rubbed from the teeth as they pass 
through the clothing. Thus many wlio have been bitten by mad 
animals have escaped hydrophobia without having the wound 
either cut out or cauterized with a red hot iron, having relied 
upon some reputed specific, such as elecampane stewed in milk, 
or other equally simple preparation, which could have had no 
possible effect in preventing the absorption of the poison, if it had 
been deposited in the wound. It is doubtful whether hydropho- 
bia was ever prevented in a single instance by any of these re- 
puted preventives. The reason wliy the disease has not come on 
when no otiier means have been used than those falsely called 
preventives, is simply because the poison was either rubbed from 
the teeth of the animal by the clothing, or from some other cause 
did not happen to be deposited in the wound. 

A case of hydropliobia occurred not long since in Lancaster 



HYDROPHOBIA. 245 

county, Pa. The patient after being bitten by a mad dog, used 
no other means to prevent the disease than a preparation that 
was supposed to be a certain preventive to the disease. Poison, 
however, happened to be deposited in the wound, and being al- 
lowed to remain there, it was absorbed, and by contaminating 
the system, brought on hydrophobia, of which the patient died. 

Means to be employed to prevent Hydrophobia* — Any one on be- 
ing bitten by a mad dog, or other rabid animal, should immedi- 
ately have the wound washed with cold water, and then, as soon 
as possible, have the surrounding flesh cut away, as deeply as the 
wound had penCitrated, or sear the whole of the wound with a red 
hot iron, or with caustic potash, in order to remove or destroy 
the poison. The sooner the parts are cut away, or cauterized, 
after the bite, the more certainly will it prevent hydrophobia. If 
this should have been neglected at first, even for several days 
after the bite, it should still be done. Doctor Marshall Hall on 
the treatment of hpdrophobia makes the following observations : 
"But the most important point in practice is to excise the part 
on which the bite has been inflicted, early, nay immediately, if 
possible, but late rather than not at all: indeed it is not too late 
if the symptoms have not yet appeared." 

Besides the local treatment above mentioned, constitutional 
treatment should at once be instituted, with a view to assist the 
constitution to expel the poison from the system, in case there 
should be a portion of it absorbed. A course of medicine must 
be administered every few days, and the patient take broken 
doses of lobelia; drink skull-cap tea; keep the bowels regu- 
lar by the use of injections; have a vapour bath administered 
every day, and use light nourishing food. When the above pre- 
ventive measures are early employed, there would be scarcely the 
possibility of the occurrence of hydrophobia. 

Symptoms of Hydrophobia, — **The only symptom which is 
never wholly absent in this disease, as it aflects the human species, 
is the extraordinary dread or horror of liquids — more especially 
of water. Patients labouring under rabies, may indeed some- 
times experience a temj)orary abatement, or even absence of 
this torturing symptom, but in all instances it occurs in a greater 
or less degree, and generally remains throughout the whole 
course of the malady. In general the mere sight of liquids, or 
the sound of pouring water from one vessel to another, brings on 
violent suflbcative spasms; and the attempt to swallow water, or 
to bring it to the lips, commonly excites a degree of horror and 
agitation truly frightful. Even the sight of polished surfaces, 
as of a mirror, or tlie rustling sound of bed curtains, or of run- 
ning water, will in the more violent grades of the disease, imme- 



246 HYDROPHOBIA. 

diately renew the spasms and feeling of hoiTor. Occasionally, 
however, this extraordinary horror is only manifested against 
water; for patients have been known to take small quantities of 
other fluids, as of soups, milk, and wine, in a luke-warm state. 
The thirst is always extremely urgent, and although the suffer- 
ing from this source is generally very great, the patient does not 
attempt to swallow any liquids. The secretion of saliva is pro- 
fuse, and from an inability to swallow it, the patient continu- 
ally spits it out in every direction, often desiring those around 
him to stand aside, as conscious that he might thereby injure 
them. During the whole course of the disease occasional remis- 
sions occur. Whilst these continue, the patient often appears 
calm, talks deliberately about his feelings or his affairs, and 
cautions those about him not to approach him too closely when 
under the paroxysm of madness, lest he should injure them. Not- 
withstanding this partial calm, there is always a peculiar wild- 
ness and appearance of alarm in the expression of the counte- 
nance; the motions are quick and hurried; tlie eyes cast about 
\^ith an air of suspicion; and if the patient attempt to lie down 
and obtain some rest, he usually soon starts up again with great 
agitation and anguish of feeling. During the exacerbations, the 
expression of the countenance is wild, furious, agitated, and ago- 
nizing; the eyes are blood-shot, sparkling, projecting, and ex- 
pressive of rage and terror; the muscles of the face, throat, and 
chest, and sometimes of the extremities, are thrown into spasms; 
respiration is interrupted or convulsive; the arms are tlirown 
about; the fists clenched; the teeth violently gnashed; the mouth 
foaming; with an unconquerable disposition to bite every thing 
that comes within the patient's reach. In violent paroxysms 
furious and maniacal ravings occur, attended often with an en- 
tire absence of consciousness. These paroxysms usually last 
from about fifteen to thirty minutes." 

There is seldom any fever in hydrophobia, except sometimes 
in the later period of the disease. The pulse is generally natu- 
ral, except towards the termination of the disease, when it be- 
comes quick, irregular, and weak. The countenance is pale, 
except during the paroxysms, — then the face is turgid and 
flushed. The power of generating heat in the system is almost 
suspended, the patient being extremely sensitive to cold and 
shudders at the slightest gust of air. The skin is dry and con- 
stricted, the bowels inactive, " and the blood drawn from a vein 
is often dissolved and very fluid." 

Duration of the Disease, — Hydrophobia, in most instances, ter- 
minates fatally by the second or third day from its commence- 
ment. It has, however, occasionally been protracted to the 
fourteenth or fifteenth day. 



HYDROPHOBIA. 247 

Treatment — When symptoms of approaching hydrophobia ap- 
pear, snch as, spasms in the throat, and a dread of water, prompt 
and energ^ic treatment must at once be instituted. The vapour 
bath, and preparations of lobelia are the means chiefly to be re- 
lied upon. 

Third Preparation of Lobelia, — This must be given in table- 
spoonful doses, and frequently repeated. Injectiens composed 
of two or three teaspoonsful of lobelia powder in luke-warm 
water must be administered and retained, with a view to relax 
the system and equalize the nervous influence. This form of 
injection should be repeated so as to cause the system to be con- 
tinually relaxed. A tablespoonful of the third preparation of 
lobelia may be occasionally added to the injection, for the pur- 
pose of stimulating the peristaltic action of the bowels, and to 
aid the curative efforts of the constitution to resist the disease. 
When the patient cannot swallow liquids, injections are to be 
chiefly relied upon. Especial care will be necessary to protect 
the patient from the influence of cold air. 

The Vapour Bath. — From experiments that have been made 
in France, the vapour bath promises to be the most effectual 
means for the cure of hydrophobia that has ever yet been tried. 
A physician in France by the name of Buisson, who, on being 
attacked with symptoms of hydrophobia, went into a vapour bath 
at the temperature of 140% and after remaining there some time, 
all the symptoms of hydrophobia left him, and he came out of 
the bath entirely cured. This took place in the first onset of 
the disease, — the only time, probably, when this or any otiier 
remedy will prove successful. M. Buisson, in a paper which he 
read before the Paris Academy of Arts and Sciences, wherein 
he details his own case, asserts also that he had, since this ex- 
periment upon liiniself, treated eighty cases of persons bitten by 
mad dogs, and succeeded by the use of vapour baths, in curing 
or preventing the disease in every case, except in that of a child 
who died during the treatment. 

There cannot be a doubt that the vapour bath is the most effect- 
ual means of removing poison from the blood. The bath should 
therefore be early and perseveringly applied, keeping the patient 
in as long as it can be borne, which, in some instances, will be 
several liours. The temperature of the bath should be as high as 
the patient can bear. About the time the patient is to leave the 
bath, a full dose of the third preparation of lobelia should be 
given. The bath must be repeated at frequent intervals, say 
every few hours, as long as it promises any hope of being suc- 
cessful. 



1 



SECTION XII. 



NEURALGIA^TIC DOULOUREUX. 

Symptoms This form of disease is characterized by a suc- 
cession of darting pains, which come on and pass away with the 
Suddenness of an electric shock, shooting along the course 
of the affected nerve. "It comes on in sudden paroxysms, with 
longer or shorter intervals of more or less complete freedom 
from suffering. In general, much pain is experienced tliroughout 
the whole course of the paroxysm, with frequent transitory 
shocks of darting pain, so extremely agonizing as often to cause 
a temporary loss of reason and consciousness." Wiien the dis- 
ease is seated about the head or face, the surrounding parts, du- 
ring the paroxysms of pain, are extremely tender, and usually 
somewhat swollen; the slightest touch suddenly causing severe 
darting pain, *^ In very violent attacks of the disease, we gen- 
erally find the neighbouring muscles affected with spasms, and 
occasionally spasmodic twitchings occur in the muscles of parts 
distant from the place where the pain is located. When the 
disease occurs in the nerves of the face, the saliva is often se- 
creted very copiously, and in nearly all instances of this kind, 
there is a profuse flow of tears from the eyes during the parox- 
ysm." 

It frequently happens in recent attacks of the disease, that the 
paroxysms come on at a particular hour of the day, preceded by 
coldness of the extremities, and sometimes chilliness; observing 
as much regularity with regard to the time of its coming on and 
passing away by perspiration, as regular intermitting fever or 
ague; the patient, during the interval between the paroxysms, 
being quite free from pain. 

OJ its Location. — Neuralgia is most apt to attack the nerves 
of the face and jaws; still, any portion of the nervous system is 
liable to be diseased in this w^ay. 

The optic nerve has occasionally been affected with neuralgia, 
the pain being described by the patient, as severe as if a red hot 
needle were passed through the centre of the eye. 

The nerves of the extremities are liable to neuralgia, the parts 
becoming suddenly swollen and inftamed, and shifting about 
from one part to another, so that a part that is extremely pain- 
ful, tender, and inflamed one day, may be entirely free from 



NEURALGIA. 249 

pain or soreness on {lie following one, another part having hecome 
affected. This fonn of disease is generally called flying rheum- 
atism. It is of no importance in practice whether the disease 
be called neuralgia or rheumatism, except that in neuralgia mus- 
tard plasters or pepper poultices should be applied to the spine : 
the constitutional treatment is to be conducted upon the same 
principles in both forms of disease. When the great sciatic 
nerve that passes througli the hip near the head of the thigh bone 
is affected, it is called sdatican or sciatic pain. 

Causes. — Neuralgia is in the majority of instances occasioned 
by taking cold, or from other causes by which the stomach and 
bowels are disordered. Frequently, however, it is produced by 
local causes, such as decayed teeth, wounds of the scalp, and 
injury of a nerve. 

Case. — Mrs. R , of Southwark, struck her forehead about 

the middle of the eyebrow, against the corner of a stone door. 
Shortly after the accident she was seized w ith violent pains in 
the part, and, shooting over that side of the head, it became 
swollen, and evidently larger than the opposite side. On 
taking cold, or when the system became disordered from 
any cause, the patient was apt to have violent paroxysms of 
darting pain in the side of the head, which was generally re- 
lieved by a sweat and emetic. Tiie disease continued to return 
at intervals, during a period of two years. A singular circum- 
stance connected with this case, was that the teeth of the upper 
jaw of the affected side, became entirely encased with tartar, ex- 
cepting their crowns. 

Case. — Miss -, of New Jersey, had been subject to fre- 
quent attacks of neuralgia in one side of her face during a pe- 
riod of eighteen months, accompanied with loss of digestion and 
continued painful diarrhoea. This patient experienced scarcely 
any benefit from medical treatment until she had some decayed 
teeth extracted from the upper jaw of the affected side, upon 
which the pains ceased, and her general health was restored. 

Treatment.-— There are few cases of neuralgia in which the 
stomach and bowels are not prominently disordered in the first 
stages of t!ie disease, requiring the employment of emetics to 
cleanse the stomach, ancl tlie use of stimulants and external 
warmth to promote perspiration. 

Of the Vapour Batli. — Whether the disease be of recent occur- 
rence, or of long continuance, the use of the vapour batli is par- 
ticularly indicated. There are probably few physicians who 

2 G 



250 NEURALGIA. 

have used the vapour bath extensively in neuralgia that have not 
sometimes found it to cure the disease after every other remedy 
had failed. In the treatment of neuralgia it is of the greatest 
importance to bring on perspiration, and favour its continuance 
by the application of external warmth, together with the use of 
pure stimulants internally. 

After a vapour bath the affected parts should be anointed with 
the stimulating liniment, or other stimulating preparations : No. 
6, or third preparation of lobelia. 

Emetics are peculiarly beneficial in all recent cases, and when- 
ever the disease is occasioned by constitutional disorder. I have 
repeatedly observed immediate and complete relief afforded by 
the operation of an emetic. 

Even when tic douloureux is produced by local causes, such 
as decayed teeth, or injuries of the head, emetics, especially 
when preceded by the vapour bath, will prove the most effectual^ 
and sometimes the only means of relief. 

Injections are beneficial when the disease is fixed about the 
head, accompanied with a determination of blood to the head, 
and coldness of the feet. Cases of this kind may, very gener- 
ally be relieved by placing the feet in warm water, and employ- 
ing a stimulating injection to relieve the bowels, followed by 
one composed of lobelia powder and warm water, and retained 
with a view to relax the system, and equalize the circulation. 

Stimulants. — When the attack is violent and protracted, be- 
sides the use of emetics, and the vapour bath, the patient should 
take freely of capsicum or composition, together with broken 
doses of lobelia. 

Compound Lobelia Pills. — When the disease has become deep- 
ly seated, requiring a long course of treatment, the above pills 
may be substituted for other stimulants, and the No. 3 pills may 
be used as anti-canker medicine. 

Charcoal. — A superabundance of acid in the stomach commonly 
attends neuralgia, for which I have found the purified charcoal 
a valuable remedy. It may be prepared in composition or spice 
bitter tea, and taken three or four times a day. The charcoal 
is more particularly adapted to chronic cases of neuralgia, at- 
tended with acidity of the stomach, and costive bowels. 

When the disease occurs periodically, like ordinary ague, 
the patient being free from pain during the interval between the 
paroxysms, the case should be treated precisely as a case of in- 
termitting fever or ague: first by cleansing the stomach, and using 



NEURALGIA. 251 

freely of pure stimulants until the tongue begins to clean, and 
the secretions of the skin and mucous membrane are restored ; 
and then by giving freely of tonics, of which Peruvian bark or 
quinine are the most efficient. 

In neuralgia of the extremities, usually termed flying rheum- 
atism, besides the constitutional treatment already described, 
benefit may be derived by stimulating applications along the 
course of tlie spine, stimulating liniment, mustard plasters, or 
pepper poultices. 

For *' ague in the face," which is only another name for neu- 
ralgia. Dr. Thomson recommends a portion of cayenne pepper 
wrapped in gauze or book muslin wet with No. 6, and applied 
between the cheek and the jaw of the affected side. This will 
cause the secretions to flow freely, and relieve the pain. I at- 
tended an old lady in Southwark, who had a severe attack of 
neuralgia in the lower jaw, who experienced relief by keeping a 
portion of the liquid of the third preparation of lohelia in the 
mouth. The greatest benefit, however, was derived from the 
use of stimulating injections containing a portion of lobelia, to- 
gether with the vapour bath, and by the system being kept 
slightly relaxed by broken doses of lobelia. 

When neuralgia is brought on by decayed teeth, they must be 
removed before a permanent cure can be loolved for. It is not a 
proper time to extract teeth during r. paroxysm of pain, more es- 
pecially if the jaw should be swollen and inflamed. 

In sciatica, (neuralgia in the hip,) besides the '^ course of medi- 
cinCf'' and general constitutional treatment already described, 
benefit may be obtained by the internal use of the oil of turpen- 
tine. A teaspoonful may be taken three times a day before meals. 
It may be taken mixed with a small portion of honey, or rubbed 
up with a teaspoonful of sugar, and then adding a little water. 

J^euralgia of the Stomach is characterized by severe pain at 
the pit of the stomach, wliich often darts into the breast and to 
the spine, and is ^' rather relieved than aggravated by pressure." 
The pain is often relieved by taking a full meal, or a draught of 
stimulating drink. The tongue is covered with a white fur; the 
appetite variable, sometimes natural, at others craving, and then 
again extremely indifferent. There is an abundant flow of saliva; 
absence of thirst: and often a repugnance to liquids. The pain 
which is relieved by eating, is apt to return a few hours after 
meals, accompanied with a feeling of weight at the stomach; 
harassing belch ings, and extreme depression of mind. In severe 
cases " the patient sometimes experiences difiiculty of breathing, 
palpitations of the heart, wandering pains and peculiar sensations 
of coldness, especially in the arms, loins, and lower extremities. 
The sleep is sometimes good, sometimes agitated, and sometimes 



252 DROPSY. 

the patient is unable to sleep at all: yet in the morning the pa- 
tient gets up refreshed, and feels quite well, till breakfast renews 
the suffering. 

Many of the symptoms attending neuralgia of the stomach, are 
such as frequently accompany ordinary dyspepsia, so that it may 
be diificult to determine whether the disease be ordinary dys- 
pepsia, or neuralgia. The same general plan of treatment, how- 
ever, will be suited to each form of disease, varying the reme- 
dies to suit the emergency of the case. When the symptoms are 
very distressing, a course of medicine will be proper, more es- 
pecially wlien the distress comes on after meals. A teaspoonful 
of the tincture of lobelia, taken in a tablespoonful of warm water, 
or mint tea, will seldom fail of relieving neuralgic pains in the 
stomach. It may be necessary, however, to repeat the dose. 
*M have myself," says Dr. Eberle, *' suffered much from this 
complaint, (neuralgia of the stomach,) and have taken opium in 
large doses; but I have found another remedy, which is less 
ruinous in its consequences, and far more permanent in its good 
effects, than this narcotic. This remedy is the saturated tincture 
of lobelia ivjiata; a few tablespoonsful of which has never failed 
to give me speedy relief, and to procure me long intervals of ex- 
emption from the disease. I have also," says the Doctor, '^ used 
it in the case of a gentleman in this city, with the happiest effect, 
but further than this my experience in the use of this article does 
not go.'' 

Stimulating Liniments, and various volatile lotions, may be 
applied externally with much advantage in cases of neuralgia. 



CHAPTER VIII. 

SECTIOX I. 

BROFSF. 



Dropsy is an unnatural accumulation of fluid in one or more 
of the cavities of the body, or in the cellular tissue, interposed 
between the skin and flesh. 

Classijication of Dropsy.— 1st Ascitis — When the fluid is col- 
lected in the cavity of the abdomen. 

2d. Ilydroihorax, — When the effusion takes place in the cavity 
of the chest. 

3d. Jinasarca^ — Dropsy in the cellular tissue. 



DROPSY. 253 

In many instances dropsical effusions take place in various 
parts of tlie body at the same time. Thus in some patients there 
are ascetis, hydrothorax, and anasarca, all at once. 

General Causes of Dropsij. — These are, ^^obstructions to the 
flow of venous blood," arising from disease of the liver, heart, 
or lungs: excessive loss of blood; disease of the kidneys; debil- 
ity, especially after scarlet fever and measles; chronic diarrhoea; 
the use of arsenic; purging with drastic cathartics; or the 
abuse of mercury. In marshy districts of country dropsy often 
succeeds imperfectly cured ague. Exposure to wet and cold fre- 
quently causes dropsy in those predisposed to this form of dis- 
ease. 

In a great majority of cases dropsy comes on gradually; yet, 
in some instances the dropsical condition has been experienced 
very suddenly. Professor Chapman mentions the case of a gen- 
tleman from Virginia who, by plunging into a cold bath, the 
body being at the same time greatly fatigued and in a free per- 
spiration from severe exercise, brought on a dropsical effusion in 
a few hours after. Another gentleman from South Carolina 
went into a very hot water bath, after a fatiguing ride on horse- 
baclt one very hot day, and was also taken suddenly with dropsy. 
In another instance dropsy was suddenly produced by a person 
lying down on the ice, who was much fatigued by skating. He 
was seized with cold, which was followed in a few days by 
dropsy. 

The General Sijmptoms of Constitutional Disorder attending 
Dropsy are, languor and lassitude; paleness of countenance; a 
dry and husky skin, without any tendency to perspiration; gen- 
eral coldness and torpor of the system; scanty and high-colored 
urine; constipation of the bowels, or the stools of an unnatural 
appearance; and the appetite variable, yet generally impaired. 

Dropsy is the effect of an obstruction in some important or- 
gan, or of general debility and derangement throughout the sys- 
tem. 

1. Ascitis— Drops?/ in the cavity of the Abdomen. — Dropsy in 
the Cavity of the abdomen is generally associated with an exten- 
sively diseased liver or spleen, occasioned, in most instances, 
either by drunkenness, long-continued agues, or inveterate dys- 
pepsia. Dropsy, however, being the effect of previous disease 
and debility, may therefore be produced by almost any debili- 
tating influence, such as cold and dampness, a sudden check to 
perspiration, confinement in foul air, or the use of unwholesome 
food. 

Pregnancy, and tumours in the cavity of the abdomen, have, 



254 DROPSY. 

in some instances, been mistaken for dropsy. A collection of 
water in the cavity of the belly, however, may be very readily 
distinguished from a tumour, or from pregnancy. One of the 
surest means for ascertaining the presence of water, is by plac- 
ing the palm of the hand on one side of the belly, and with the 
other hand to tap lightly on the opposite side, which will cause a 
iVisiinct fluctuation or wave to be felt by the hand placed on the 
abdomen, provided there be a collection of fluid within. In drop- 
sy the swelling is uniform on both sides of the abdomen, and 
when the patient lies on the back, the liquids will press out the 
sides and flatten the middle; whereas, in pregnancy or tumours, 
there is usually more swelling in one side, and the form of the 
swelling is but slightly altered by lying on the hack. A collec- 
tion of water in the cavity of the abdomen will occasion difficulty 
of breathing, from the pressure of the fluid upon the diaphragm, 
when the patient lies dow^n with the hips raised higher than the 
chest. Dropsy is attended with symptoms of constitutional dis- 
order, which are mostly absent in pregnancy. 

Dropsy of the abdomen has been cured in many instances by 
the Thomsonian practice, when other plans of treatment have 
failed. 

2. Hydrothorax — Bropsy in the Chest. — Dropsy in the 
chest, like other forms of dropsy, is the consequence of a disor- 
dered condition of the general system, or arises from obstruction 
in some important organ. In this form of dropsy patients sel- 
dom experience much inconvenience from it, until the accumula- 
tion of water becomes so great as to interfere w ith respiration. 
The dropsy may take place only in one side of the chest, yet 
more commonly the eff'usion occurs in both sides. 

JDistingnishing Symptoms. — ^These are, a dull sound produced 
by percussion, (tapping on the chest with the ends of the fingers,) 
whilst the patient is in a sitting posture. Great difficulty of 
breathing pi'oduced by pressing firmly upon the abdomen, just 
below the ribs, which, by forcing up the diaphragm, causes the 
water to rise in the chest, and thus it interferes with respira- 
tion. A sense of suffocation on lying down; ** starting during 
sleep;" great agitation; and an habitual cough. 

The symptoms above mentioned, however, may attend other 
forms of disease, without there heing an accumulation of 
water in the chest. Thus asthma and disease of the heart may 
occasion the same oppression of hreathing that occurs in dropsy 
of the chest. The same difficulty of lying down attends asthma 
as in dropsy of the chest. Asthma, however, usually comes on 
by paroxysms, whereas in dropsy of the chest the oppression of 
breathing and inability to lie with the breast low^ continues 



DROPSY. 255 

without intermission. If, together with the symptoms before 
mentioned, characterizing dropsy of tlie chest, there be a ten- 
dency to dropsy in other parts, as in the feet, and beneath the skin 
covering the chest, sufficient evidence will be afforded to war- 
rant the conclusion that there is water in the cliest; and although 
it may be difficult to determine whether the disease be dropsy, 
asthma, or disease of the heart, it should occasion no embarrass- 
ment to the practitioner in directing the treatment, for the same 
general plan of treatment will be equally appropriate to each 
case. Tiius the vapour bath which will relieve asthma, will 
prove beneficial in dropsy, wherever it may be located. Lobelia, 
which is the most effectual remedy for asthma, is the article 
chiefly to be relied upon, botli in dropsy of the chest, and disease 
of the heart. 

In dropsy of the chest or abdomen, a sudden subsidence of the 
swelling in the legs and feet, without an increased secretion of 
urine, is an unfavourable symptom, as in most instances the 
patient dies soon after this occurs, and sometimes very sud- 
denly, 

3. AjfASARCA — Cellular Dropsij. — This form of dropsy gen- 
erally commences in the feet, and the swelling ascends, and 
in some cases extends over the whole surface of the body. Some- 
times the swelling will be confined to the legs and feet; or to the 
face, hands, and feet. 

Pressing a finger firmly against the swelling, will leave an 
indentation or pit, whicii will remain a considerable length of 
time after the pressure has been removed. This serves to dis- 
tinguish cellular dropsy from swellings arising from other 
causes. Thus milk-swelling, as it is termed, has the appear- 
ance of dropsy, but pressing a finger upon it, will not leave 
such indentations as remain after pressure upon dropsical sw^el- 
lings. 

Geiierul Causes. — Cellular dropsy is peculiarly liable to occur 
from exposure to cold after scarlet fever and measles. Females 
arc liable to dropsy of the lower limbs during the later period 
of pregnancy, in consequence of pressure upon the veins, thus 
obstructing the circulation. Extreme exhaustion from loss of 
blood; *' exposure to cold when the system is under the influence 
of mercury; the long continued use of arsenic;" chronic diar- 
rhoea; "repelled cutaneous eruptions; great debility and ex- 
haustion; chronic gout; organic disease of the kidneys, &c., 
are the most common causes of this variety of dropsy. 

Dropsy of the cellular tissue is more readily cured than dropsy 
of the chest or abdomen. More especially is it less difficult of 



256 DROPSY. 

cure when it comes on suddenly, and is accompanied by fever 
and considerable activity of pulse, without great prostration of 
strength. But when it comes on very gradually, attended with 
coldness, and extreme torpor of the system, or when it depends 
upon extensive derangement of important functions, as those of 
the stomach, liver, kidneys, or spleen, the cure is mostly very 
difficult. Still more difficult is it when connected with dropsy 
of the abdomen or chest, constituting general dropsy* 

Treatment of Br op sy in general, — The most important indica- 
tion for the cure of dropsy, is to correct the disordered condition 
that causes it. 

An occasional course of medicine is the most effectual means 
to restore a healthy action throughout the system, and it will b-e 
required in most cases of dropsy. As a general rule the course 
should be repeated more frequently in the early stage of dropsy 
than when it has been of long standing. 

Of the Course of Medicine. — 1st. The Vapour Bath. — This ful- 
fils important indications in the treatment of dropsy. It im- 
proves the condition of tlie skin — effects a determination to the 
surface — excites free perspiration — diffuses a natural warmth 
through the system, and by augmenting sensibility, causes the 
emetic to operate more effectually. It is an ohservation of Dr. 
Thomson's, that one emetic after steaming will prove as effectual 
in removing disease, as four emetics given without the bath. A 
vapour bath in the evening will enable a patient to rest more 
comfortably through the night. Dropsical swellings of the limbs 
that occur after scarlet fever and measles, may be effectually 
removed in many instances by the use of vapour baths, together 
with giving a dose of composition powder three or four times a 
day. 

2d. The Emetic. — The most decided benefit is derived from 
the frequent administration of emetics, more especially in the 
early period of dropsy. Cases of dropsy have been cured by 
spontaneous vomiting. Dr. Eberle mentions a case of dropsy 
of the abdomen cured by spontaneous protracted vomiting. The 
relaxation produced by the lobelia, together with the retching 
and straining effort to vomit, will, in some instances, overcome 
obstructions in the liver and other organs. In general dropsy, 
when the internal heat, or constitutional energies are greatly 
exhausted, and the disease is of long continuance, emetics will 
be of little use, except as a means of affording relief wlien there 
is great oppression at the pit of the stomach. When patients 
are very low, the emetic should be made of tlie liquid of the third 
preparation of lobelia in strong bayberry tea, or infuse the lobe- 



DROPSY. 257 

lia powder in thebayberry tea, and add two or tbree teaspoons- 
ful of No. 6 to each dose of the emetic. In the earlier period of 
the disease, and more particularly if fever exist, the system 
should be relaxed by a free use of the lobelia. An injection of 
lobelia powder in luke-warm water, retained, will assist in re- 
lieving the system, and will also favour the operation of the 
emetic. Patients sometimes experience much distress during 
the operation of an emetic, in deeply seated complaints, but re- 
alize great benefit after the operation, from its effect. 

3d. Injections. — If the bowels be costive, an injection should 
be administered previously to the bath. Stimulating injections, 
containing a portion of lobelia, exert a beneficial influence, by 
arousing tiie nervous energy, and thus give an additional im- 
pulse to tlie circulation of the blood, and an increased action to 
the absorbent vessels* The kidneys may also be stimulated to 
increased action by injections. To favour the operation of the me- 
dicine, the patient must be kept warm, and take freely of capsi- 
cum, or composition tea. 

4th. Jl Vapour Batlh after the emetic, completes the course of 
medicine. The patient should be allowed to remain in bed after 
the operation of the emetic, as long as he continues in a perspi- 
ration. When perspiration ceases, the second bath may be ap- 
plied; and the patient showered with cold water, or washed with 
spirits, rubbed dry, and the surface bathed with some stimulant, 
such as No. 6, pepper sauce, or stimulating liniment. After 
this the patient must be kept warm, either in bed or by being 
warmly clad, and continue the use of stimulating medicines, to 
** support the internal heat," and maintain a determination to 
the surface. Where perspiration cannot be continued, or an in- 
crease in the secretion of urine be induced, the use of the usual 
stimulants, capsicum or composition tea will be required. The 
medicine must be given chiefly in the form of pills, or the pow- 
ders taken dry, or in a very small quantity of water. The com- 
pound lobelia pills answer both as a stimulant and relaxant, and 
they should be taken in sufficient quantity to occasion a slight 
and continued nausea. 

J\*eiroines. — Scullcap or valerian tea, may be used at night to 
promote sleep, or the nervine may be taken with other medi» 
cine. 

Diuretics. — In certain conditions of the system, the use of di- 
uretic medicines will be beneficial, by increasing the secretion 
of urine. An increased flow of which is among the first symp- 
toms indicating a favourable termination of dropsy. But where 

2 H 



Q5S DROPSY. 

the loss of power in the kidneys depends upon a great degree of 
constitutional derangement, it will be useless to rely upon diu- 
retics to cure the dropsy. First resort to general constitutional 
treatment, and as the health improves, diuretics will be benefi- 
cial. A great variety of diuretics are employed in tlie treatment 
of dropsy. The following, I am informed, was a favourite re- 
medy with the late Dr. Parrish. 

Take parsley root, English mustard seed, horse radish, and 
burdock root, grated fine; put them into a stone jug with a pro- 
per portion of sound cider. To be taken several times a day. 
If this should increase the flow of urine without occasioning un- 
pleasant feelings in the stomach, it should be continued as long 
as it is found to be agreeable. 

A strong tea of the sumac, more especially of the roots and 
hemes, answers in some instances as a diuretic, besides the im- 
portant indication which it fulfils of cleansing the stomach and 
bowels of " canker,^* 

Oil of Juniper, — The diuretic effect of Holland gin depends 
upon the oil of juniper contained in it. Juniper oil is one of 
the best of diuretics, and may be used with advantage in many 
cases of dropsy. The dose of the oil is from five to fifteen or 
even thirty drops, rolled up with a teaspoonful of slippery elm 
powder and sugar, adding a little water before taking. To 
be repeated three or four times a day. 

Whilst taking diuretics, the vapour bath may be occasionally 
administered, and the patient must take freely of the compound 
lobelia pills, or capsicum tea. 

In most cases of dropsy of the belly, it becomes necessary to 
drain off the water by tapping. This, though a very easy and 
safe operation, requires to be done by one acquainted with the 
operation. I shall, therefore, not attempt to give directions for 
performing it, but merely observe, that I have found a thumb 
laneet the best instrument for tapping in dropsy; a canula closed 
at the end and perforated with holes to admit the escape of the 
fluid, is to be incerted when tlie lancet is withdrawn. With a 
lancet in good order, the operation of tapping does not occasion 
more pain to the patient than is caused by bleeding in the arm. 
The trochar (the instrument generally employed for tapping) has 
no advantage whatever over the lancet, and with the latter tlie 
operation can be performed with much less difficulty, and with 
one tenth of the pain to the patient that would be caused by the 
introduction of the trochar. In some instances the operation of 
tapping requires to be several times repeated. There are cases 
recorded where the operation has been performed more than one 
hundred times in the same patient. Even in cases where there 
is no probability of a cure being effected, the operation of tap- 



DROPSY. 259 

ping will frequently be called for as the only means of relief to 
the patient. 

Tonics. — When the disease has been of long standing, the 
stronger kinds of tonics should be used, more especially after a 
few courses of medicine have been administered. A strong tea 
of quassia, wormwood, balmony, or golden seal, may be taken 
once or twice a day, together with the pills before mentioned. 

External application. — Bandaging the swollen parts, more 
especially tlie legs and abdomen will be beneficial; and after 
tapping the use of a bandage becomes indispensible. Before ap- 
plying the bandage, the stimulating liniment. No. 6, or pepper 
sauce must be applied to the skin; or the bandage must be wet 
with strong salt water, and dried before it be applied. Fric- 
tions of the surface with a salted towel or flesh brush will be of 
more or less benefit. 

Elaterium, or the squirting cucumber, is a remedy generally 
employed in the treatment of dropsy by physicians of the (dd 
school. It is a powerful cathartic, acting with great violence 
upon the stomach and bowels, often exciting inflammation and 
sometimes occasioning death. The elaterium will sometimes 
remove the water, but the injury which it does to the digestive 
organs, will more than counterbalance the benefit derived from 
the reduction of the dropsy. Dropsical affections removed in 
this way are almost sure to return, except when the effusion is 
confined to the lower extremities, and which might have been 
removed by vapour baths and the use of composition. And 
when dropsy returns, after having been removed by the use of 
elaterium, or other hjdrogogue cathartic, the digestive powers 
being prostrated by the cathartic, will increase the difficulty of 
permanently effecting a cure. 

Dr. Thomson in his Narrative makes mention of several cases 
of dropsy, in which he succeeded in effecting a cure, after the 
regular practice had failed, and the disease had been considered 
as incurable. He treated them upon his general plan of giving 
freely of the '^ hot medicine, to support inlerual heat, and to con- 
tinue perspiration, assisted by external warmth, and occasional- 
ly by a course of medicine. And in dropsy of the abdomen, he 
drew off the water by tapping, in the usual way, after passing 
the patient through several courses of medicine, in order to re-^ 
store a more healthy action in the system, and thus lessen the 
liability to a return of the dropsy. 

The character of the fluid drawn off by tapping varies in dif- 
ferent cases. Sometimes it will be high coloured like strong 



260 BROPSY. 

coffee, or it may be thick and ropy; more frequently, however, 
it resembles ordinary urine. 

Hydrocele^ or dropsy of the scrotum, — When this occurs in in- 
fants, as it sometimes docs at birth, it is called congenital hydro- 
cele. It may be distinguished from hernia, by the transparency 
of the parts, and the absence of slight vermicular motions. It is 
generally readily cured in infants and children, by applying 
some mild stimulant, the scrotum being ke])t in a suspensary 
bag, by which moderate pressure upon the parts is maintained. 

Hydrocele in adults, frequently demands the operation of tap- 
ping the scrotum. From a tendency to a reaccumulation of the 
water, the operation will require to be repeated many times, in 
some cases, before a cure takes place. The late Dr. PJiysic re- 
lied almost exclusively on tapping for the cure of hydrocele, re^ 
peating the operation until the water ceased to accumulate. 

Hydrocephalus — Dropsy in the Brain, — Effusion of water 
in the brain rarely occurs except in children, between two and 
five years of age. 

Symptoms, — Pain in the head, especially across the brows, or 
in the back of the neck; constant motion of one or both hands; 
sickness and efforts to vomit; a disposition to be in a lying pos- 
ture; a deranged condition of the bowels; an eruption on the 
face, resembling very minute drops of water; stupour and con- 
vulsions, attend dropsy of the brain. 

The above symptoms usually accompany hydrocephalus. Pre- 
cisely the same group of symptoms occur, however, without there 
being any effusion of water on the brain. Dr. Chapman recently 
attended in consultation on a case, ^^'here there was every cha- 
racteristic symptom of dropsy of the brain, but on examination 
after death, there was no appearance of water in that organ. 

Causes, — An originally feeble constitution; exhaustion from 
disease; exposure to wet and cold; together with the reducing plan 
of treatment practised by the medical profession, constitute 
the principal source of dropsy of the brain. Severe attacks of 
diarrhoea or infantile cholera, are frequently attended with effu- 
sion of water in the brain; the dropsy being m.erely a link in the 
chain of effects resulting from loss of vital power. Active purg- 
ing, when the system is in a state of exhaustion, may occasion 
symptoms indicative of hydrocephalus. 

Dr. Travcrs, who in reputation is excelled by few in the pro- 
fession, advances the opinion, that the depletive treatment pur- 
sued by the profession occasions, in many instances, those symp- 



DROPSY. i^SI 

toms indicative of dropsy in the brain, winch so frequentlj are 
found in children. 

A physician discovers symptoms of inflammation in the heady, 
and adopts a depletive course of treatment under the false im- 
pression that the inflammation is the source of danger. A child 
is taken, for instance, with cholera morbus, and the purging 
and vomiting continuing for some time, the brain consequently 
becomes exhausted, and nature sets up her restorative action, oc- 
casioning symptoms of inflammation of the brain: this feverish 
or inflammatory action is the means which nature employs to 
restore the lost vitality of the brain, and to sustain its functions, 
and these curative effbi'ts should be aided instead of being pros- 
trated by a depletive course of treatment. Where the pulse is. 
strong, and the skin hot, the chances of a cure are much greater 
than when there is general torpor and a cold skin. 

Treatment. — The existence of dropsy in the brain cannot be 
determined to a certainty, as the symptoms whicli attend collec- 
tions of water in the brain also accompany an inflammatory ac- 
tion in it. Precisely the same symptoms also arise from determi- 
nations of blood to the head from exhaustion of strength. The 
treatment, however, applicable to one case, will be equally suit- 
ed to a similar condition of the general system in the other. The 
treatment must be directed to assist the efforts of nature. The 
means to be employed are injections, the vapour bath, emetics, 
the warm foot bath, volatile stimulants applied to the head, 
whiskey or vinegar, together wdth frequent doses of stimulants, 
which may be rendered more efficacious by the addition of small 
portions of lobelia. 

Sometimes an oppressed stomach will occasion symptoms re- 
sembling those arising from inflammation of the brain, and be 
entirely relieved by the operation of an emetic. Even though 
there should not be foul matter burthening the stomach, still a 
lobelia emetic may prove beneficial, more especially if there be 
fever. 

Where there is an active determination of blood to the brain, 
accompanied by fever, the system must be kept under the influence 
of lobelia in broken doses, taken into the stomach, or adminis- 
tered by injection to the bowels. For although an inflammatory 
action be necessary to the lost vitality of the brain, still there may 
be an undue determination of blood, and concentration of nervous 
influence to the head, which may require to be regulated by the 
means above mentioned, together with the use of the vapour bath, 
foot bath, pepper poultices or mustard plasters to the feet, and 
cooling applications to the head. The strength is to be supported 
by the use of the stimulants usually employed, and by a light nour- 
ishing diet. In fine, inflammation, dropsy, and all other disor^ 



262 SCROFULA. 

tiers of tlie brain, arising from constitutional disease, are to be 
treated upon the same general principles. 

Sijmptoms denoting a recovery.-^A heavy sediment in the 
urine, or if it have a foetid smell, the pulse softening, and a run- 
7iingfrom the nose. This last, denoting the restoration of the se- 
cretions of the nose, is to be depended upon more than any other 
symptom, as indicative of a recovery. 

Bad Symptoms. — Blindness or deafness, deep stupour, spasms, 
a copious discharge of pale urine, watery discharge from the 
bowels, and twitchings of the muscles are symptoms wliich indi- 
cate an unfavourable termination of the case. 



CHAPTER IX. 



SECTION I. 



SCROFULA. 



The name scrofula is applied to forms of disease differing 
materially in their general aspect. Thus, a child afflicted with 
sore eyes is said to be scrofulous; another has an eruption on 
the skin which is called scrofula; a third will have a disease in 
the hip, which receives the name of scrofula; whilst a fourth has 
swTllings in the glands of the neck, also called scrofula. These 
are forms of disease which are apt to occur in persons of delicate 
and feeble constitutions, generally termed scrqfnlous. 

Children possessing what is called the scrofulous constitution 
are usually of small frame, with pale and delicate skin; the mus- 
cles imperfectly developed, the flesh being soft and flaccid, with 
light hair, blue or grey eyes, long eye-lashes and large upper lip. 
The head (particularly the posterior part) is usually large, and 
the temples flattened or somewhat depressed. There is, in gen- 
eral, a great proneness to slight catarrhal affections during 
which the wings of the nose and the upper lip are apt to become 
swollen. The edges of the eye-lids are much dis])osed to become 
inflamed, and when the scrofulous tendency is strongly devel- 



SCROFULA. 263 

oped, the tarsi (under edge of the eye-lids) <^are constantly red 
and tender." The digestive powers are feeble, the appetite va- 
riable, and the bowels seldom in a healthy condition. The pa- 
tient is very sensitive to cold, and his temper generally irritable. 
The intellectual powers are usually very strong. 

In female children of scrofulous constitution, '^a leucorrhjeal 
discharge is apt to occur from time to time; and in very young 
children, excoriations behind the ears, scaly eruptions about the 
head, and lips," and sore eyes are frequently observed. 

It very often happens that children exhibit a strong tendency 
to scrofula, but become healthy without the disease having ever 
become further developed, except occasionally by slight swellings 
in the glands about the neck. Sometimes the disease breaks out 
early in life, and in others it does not appear until after the age 
of puberty. In some the disease is of short duration, the patient 
soon becoming entirely healthy; in others the constitution sinks 
under the ravages of the disease, and the case terminates fatally, 
most commonly by tubercular consumption. Occasionally the 
disease breaks out in childhood, and continues for years, or even 
during a long life, the patient enjoying tolerably good health 
with the exception of swelling of the glands about the neck, and 
probably more or less discharge of matter from those that have 
suppurated; or if the disease be located in the hip, the patient 
may recover, except from the lameness and deformity which al- 
most always follows as a consequence of the hip disease. 

Causes. — Altliough scrofula is far more likely to occur in 
chiidj'cn of a peculiar delicacy of constitution, still it is occasion- 
ally ob^served in those who have inherited sound constitutions. 
The disease essentially consists in debility and obstruction in 
the glands; and the same cause, for instance, exposure to cold, 
producing obstructions in the glands of one of a scrofulous con- 
stitution, may, by frequent repetition, together with unwholesome 
diet and confinement in close apartments occasion the disease in 
one of a naturally good constitution. 

Children are especially liable to slight swelling of the glands 
under the jaw and on the neck, during teething, and when they 
have eruptions behind the ears or on the head. Arising from 
such causes, these slight enlargements of the glands almost al- 
^vays pass away without any attending serious consequences. 

**A cold, humid, and variable atmosphere, more especially 
when aided by deficient nourishment, appears to have a strong 
tendency to favour the development of the scrofulous habit." 
Children who work in the large cotton and woolen manufacto- 
tories of England are peculiarly liable to scrofula. The disease 
also prevails among the children of the poor, w hen they are bad- 



■H 



$64 ftCtioi'tJLl. 

ly cktW, sleep in sin all close rooms, and who live on unwhole- 
some food, badly cooked. 

Scrofula frequently occurs as a consequence of taking cold 
after measles, scarlet feyer, or whooping cough. 

Freventives. — With children who exhibit marks of a constitu- 
tional tendency to scrofula, a small frame, pale skin, soft and flac- 
cid condition of the flesh, light fine and tliin hair, long and slender 
neck, with a weak and irregular appetite, an unhealthy condi- 
tion of the bowels, and a tendency to eruptions about the liead, 
or to swelling in the glands of the neck, means should be employ- 
ed to renovate and strengthen the constitution, in order to pre- 
vent the development of scrofula. Regular exercise in the open 
air, warm clothing, sleeping in a large room, wholesome, nour- 
ishing food, shower baths, or bathing in cold salt water in the 
morning, and friction to the surface, are the means chiefly to be 
relied upon, not only for renovating the constitution and prevent- 
ing the development of scrofula, but they are also important aux- 
iliaries in the cure of the disease after it has become manifest. ^ 

Treatment of Scrofulous Tumour s^ commonly called Kings 
MviL — When the glands about the neck become swollen, and 
hard, but not inflamed, the tumour should be rubbed gently fif- 
teen minutes, or half an hour, every morning and evening, and 
a poultice of flour or slippery elm powder wet with salt water 
applied. The poultice to be kept on night and day, and occasion- 
ally wet with saltwater* If the appetite he vai'iable, or the bowels 
are in an unhealthy condition, an emetic or full course of medicine 
will be of signal benefit in aiding to diminish or scatter the swel- 
ling of the glands. The course of medicine must be repeated 
w^henever the condition of the patient appears to require it. 

Compound Lobelia Pills. — One or two of the compound lobelia 
pills after meals, and at bed time, will be useful, by correcting 
the secretions of the stomach and bowels, and preventing cos- 
tiveness. 

Tonics are proper in every stage of scrofula, when the patient 
is languid and weak. The spice bitters, gentian, Virginia snake 
root, quinine, or garden bitters, may be employed, occasionally 
changing them, as the fancy of the patient, or the judgment of 
others may determine. 

The Diet must be nourishing and easy of digestion. Boiled 
milk and toast, eggs, custards, mutton, the tender part of fresh 
beef, all kinds of wild game, stale bread and butter, potatoes, and 
boiled rice, are suitable articles of diet in scrofula. 



SCROFULA. 265 

Fresh air, moderate exercise, cleaiilitiess^ salt water baths, 
frictions to the surface witli a flesh brush, or salted towel, are 
of as much importance in the cure of scrofula as medical treat- 
ment. Close and crowded school rooms, are improper places 
for children predisposed to scrofula. It is equally important 
for such children to avoid getting their feet damp. It is not 
sufficient to wear merely tight shoes, but the soles should be very 
thick, to prevent dampness from penetrating them. It is of lit- 
tle avail, as a preventive to disease, to clothe the body warm, 
whilst the feet are unprotected from cold and dampness. 

TPlien a scrofulous tumour becomes jjainful and iujiamed, warm 
emollient poultices must be applied with a view to favour suppu- 
ration, and prevent its being converted into an indolent ulcer. 
Elm, pounded cracker, white pond lilly and ginger, combined 
together, and whet with warm water, will form a suitable poul- 
tice. The poultice may require to be Avet occasionally with 
warm water, to prevent its being hard and dry. If the disease 
be accompanied by high fever and severe pain, a course of medi- 
cine will be required, together wit^i the use of broken doses of 
lobelia, and once or twice a day a teacup half full of strong bay- 
berry tea, or four or five of the No. 3 pills. If the tumour have 
been inflamed, throbbing, and at tlie same time the patient af- 
fected with chilliness, follovved by fever, and after the lapse of 
some days or probably a week or more, the tumour becomes soft 
and fluctuates under the fingers, and a blush of red is observed 
on the skin, the tumour may be opened and the same stimulating 
poultice applied as long as the abscess discharges; after which 
some kind of salve or plaster must be applied to protect the part 
from the influence of the air. Abscesses along the lower jaw, 
must always be opened from inside the mouth. 

Of the Indolent dbscess. — It sometimes happens that a scrofu- 
lous tumour, after being more or less inflamed for a time be- 
comes soft, and exiiibits positive signs of its containing pus, but 
there will be no pain in the part, and t!ie skin over the tumour 
will be cool, the patient clear of fever, and the system in a tor- 
pid condition. This condition of things arises as a consequence 
of the constitutional strengtii being too weak to raise or con- 
tinue the proper degree of ijiflammation sufficient to carry on 
healthy suppuration. The efforts of nature subside without ac- 
complishing its design, and the abscess becomes converted into 
one of an indolent ciiaracter, w hich should not be opened, but 
stimulating liniments or strengthening plasters applied to the 
tumour, and the constitutional energies restored by the use of 
tonics, the vaporr bath, and sliowcr bath; a course of medicine 
every few weeks to cleanse the stomach and bowels: and a cold 

2 1 



266 SCROEUliA. 

salt water shower bath in the morning, provided the patient does 
not remain chilly after it. If a glow of warmth comes on in the 
course of fifteen minutes or half an hour after the bath, it will 
certainly be beneficial. These means, together with fresh air 
and wholesome food, may succeed in causing the absorption of 
the contents of the abscess; or if it should break, or require to be 
opened, the constitutional efforts will be better able to carry on 
the healing process. In all cases where a large abscess is either 
forming, or has discliarged its contents, the most nourishing 
diet must be allowed the patient to supply the system with 
strength to carry on her healing operations. In case of cold or 
indolent abscess, wine whey forms a suitable article of diet when 
the stomach is too weak to take much solid food. Under circum- 
stances of this kind bitters must also be used freely. 

J. Scrofulous Ulcer is to be known by ^^its occurring after a 
suppurated scrofulous tumour — the peculiar dull red, or purple 
colour of its edges — its remaining indolent for a length of time, 
neither increasing nor diminishing in size, and its being attended 
with that peculiar state of health which invariably prevails in 
the scrofulous constitution." 

Treatment of Scrofulous Ulcers. — Constitutional treatment is 
more important than local applications in the cure of this kind of 
ulcer. The means above mentioned for cleansing the stomach and 
bowels, and for improving the health, will be especially adapted 
to this form or stage of scrofula. Stimulating poultices must be 
applied to the ulcer, containing a large portion of astringent — 
either white pond lily, or bayberry, and the poultice wet with a 
strong tea, of the same. 

Indolent ulcers maybe stimulated to a more healthy condition 
by filling them with dry, and finely pulverized marsh rosemary, 
bayberry, or rhattany root, and then apply a poultice or salve 
over the whole, repeating it morning and evening. 

*' We have known a sea voyage to heal scrofulous ulcers of 
bad character which had resisted years of medical treatment." 
Marshall Hall, 

When a scrofulous abscess, after being evacuated, continues 
to discharge more or less for a great length of time, it should be 
syringed with castile soap and water, and in order to stimulate a 
more healthy action of the parts, inject into the cavity weak 
ginger tea, or a tea made from the inner bark of a young ches- 
nut tree, repeating it every day, and apply over the surface a 
stimulating poultice, or strengthening plaster covered with pep- 
per. 

Sarsaparilla,—A simple syrup of sarsaparilla, when properly 
prepared^ may be used with decided benefit in sorofula, more es- 



GOITRE. 267 

pecially when the disease has heen of long continuance, and the 
patient feeble and emaciated. I have, in some instances, observed 
a rapid improvement in patients on taking a syrup of sarsapa- 
rilla. The cases in which I have known the most benefit derived 
from using the syrup, have been patients in whom the disease 
had apparently become exhausted, and the system left in a lan- 
guid, impoverished condition. It is questionable whether more 
benefit is not derived from the sugar of which the syrup is com- 
posed, than from the sarsaparilla. On many occasions I have 
become acquainted with cases of scrofula in which patients have 
taken from twenty to sixty bottles of Swaim's and other prepa- 
rations of sarsaparilla without experiencing any benefit from 
them. Most of the cases of remarkable cures effected by Swaim's 
Panacea, have been of the character above alluded to — the dis- 
ease having come to a stop, and the system being in a condition 
in which a syrup of sugar afforded the most appropriate kind of 
nourishment to the system, that by its use new blood was made 
more rapidly, furnishing to the system that nourisliment which 
it required in order to regain strength and flesh. 



SECTION II. 



GOITRE. 

This form of disease, although resembling scrofulous swell- 
ings of the glands, is essentially different from scrofula. 

Goitre is an enlargement of the thtjrmd gland, situated low on 
the front part of tlie neck, and covering a portion of the wind- 
pipe. Scrofula is seated in the lymphatic glands, which occupy 
a different position from the former. The thyroid gland possesses 
alow degree of vitality, and its use has never been ascertained. 
The lymphatic glands have a higher degree of vitality, and they 
are known to perform important functions. This difference of 
character between the thyroid and hjmphatic glands affords an 
explanation of the cause of the difference between goitre and 
scrofula. 

In the first stages of goitre, the tumour is soft and spongy to 
the touch, — The skin covering it has a natural appearance, *' and 
is moveable over the enlarged gland." As the disease progresses, 
the tumour becomes harder, and after the lapse of many years, 
it sometimes becomes very large, and of a gristly or cartilagi- 



268 GOITRE. 

nous structure. The usual progress of goitre is very slow, re- 
quiring many years before the tumour acquires much size, and, 
in many instances, it never becomes so large as to occasion great 
inconvenience to the patient. In some, however the tumour oc- 
cupies almost the whole of one side of the neck, extending from 
the clavicle (collar bone) to the ear. Goitre is very seldom at- 
tended with pain or inflammation, and in these particulars, it 
differs materially from scrofula in general ; yet sometimes goitre 
is attended with darting pains, when the tumour is very large 
and indurated. 

The skin and cellular tissue covering the thyroid gland, yield- 
ing readily to pressure, admit the gland to become very large, 
without pressing upon the wind-pipe to such a degree as to in- 
terfere with respiration. When the gland becomes greatly en- 
larged and hard, it generally occasions some embarrassment in 
breathing, swallowing and speaking. 

Goitre prevails epidemically among the inhabitants of valleys 
situated at the base of high mountains. '^In no part of the 
world is the disease so prevalent, and so distressing in its cha- 
racter, as in some of the valleys of the Alps and Appenines. In 
certain districts of Switzerland and Savoy, almost the whole of 
the indigenous population are more or less affected with goitrous 
enlargements. In the valley of the Rhone, at Martigny, St. 
Maurice, Aigle, Villeneune, Bourg, Lucerne, and at Dresden, 
and in the vallies of Piedmont, this disease is extremely com- 
mon." — Eberle. 

Some experienced surgeons liave mistaken goitre for aneurism 
of the carotid artery. It has likewise been mistaken for an en- 
largement of the jugular vein. When only a portion of the gland 
becomes enlarged, and remains soft, it may be difficult for even 
an experienced surgeon to determine wliether the disease be 
aneurism, enlargement of the jugular vein, or goitre. 

Causes. — Great diversity of opinion prevails among medical 
men in relation to the cause of tliis singular disease. Whilst 
some suppose it to be brouglit on by drinking water impregnated 
M ith lime, and other calcarioos substances, others have advanced 
the opinion that the use of snow w ater is the cause of the dis- 
ease. Others have contended that goitre is produced by the use 
of water entirely devoid of carbonic acid ; and others again have 
conceived it to depend upon particular articles of food. A more 
plausible theory of the origin of the disease, is that which attri- 
butes it to atmospheric iiifluences — r humid, dense atmosphere, 
and the absence of electricity in the air. ^'In many deep, damp, 
and woody valleys, goitre is extremely prevalent; but in propor- 
tion as we ascend towards the more elevated and dry situations, 
on the sides and tops of the adjacent mountains, the disease be- 



GOITRE. 269 

comes less and less frequent. It is well known, moreover, that 
when young persons affected with goitre remove from the valley 
in which the disease was contracted, to high and dry situations, 
the tumour almost always becomes considerably diminished in 
size, and in many instances disappears altogether." — Edinhiirg 
Med. and Surg. Journal. 

JVot Dangerous. — Goitre is not a dangerous form of disease, 
being veryrai'ely known to prove fatal, except in those situations 
where it prevails as an epidemic. 

Treatment. — This disease is evidently an obstruction in the 
^land, and is to be cured only by removing this obstruction. 
The means to be employed for restoring the circulation in the 
obstructed gland, are frictions with flannel, or with the warm 
hand; and the use of stimulating liniments and warm fomenta- 
tions. The application of the vapour and shower bath, and oc- 
casionally a full course of medicine, are important, more espe- 
cially in the earlier stages of the disease, whilst the tumour re- 
mains soft. 

Patients residing in a district where goitre prevails epidemic- 
ally, will derive more benefit by a removal to a more elevated 
situation, where the disease does not prevail, than from any med- 
ical treatment. 

Washing the tumour with salt water, and sea bathing, are said 
to be beneficial in removing goitre, more especially in its earlier 
stages, before the tumour becomes of a cartilaginous or gristly 
texture. 

Iodine, in the form of ointment, applied to the tumour exter- 
nally, is considered by some as an effectual remedy for dispersing 
the tumour. 



CHAPTER X. 



SECTIOir I. 



SUSPEJVSIOJ^ OF AJYIMATIOJ^ FROM BROWA^USTG, 

When a person is taken out of the water soon after drowning, 
"the face exhibits a turgid and livid appearance; tlie eyes are 
open and staring; the limbs somewhat stiff; the tongue thrust a 
little beyond the teeth; and the epigastrium tense and tumid." 

It is questionable with many physicians whether animation 
can be restored in drowned persons, after the heart lias ceased 
its motions. There is sufficient evidence, however, to establish 
a belief, that under favourable circumstances, life may possibly 
be restored, even after the heart has ceased to act. When a 
person is drowned in very cold water, it will be more difficult 
to restore animation, in consequence of the heat of the body 
having been abstracted by the cold. 

It is generally believed that in drowning, water is conveyed 
into the lungs, but as long as life remains the glottis is closed, 
preventing the admission of water into the wind-pipe. 

Treatment — As soon as the patient is rubbed dry, and covered 
warm, stimulating injections should be administered. A table- 
spoonful of the third preparation of lobelia, or even two or three 
ounces may be administered at once in luke-warm water. No 
other means can be employed that are so well calculated to arouse 
the nervous influence, and excite respiration, as powerful stim- 
ulants administered by injection to the bowels, or introduced in- 
to the stomach by means of a stomach-pump or gum-elastic 
catheter. The injection should be frequently repeated. In the 
place of the third preparation of lobelia, pepper tea or No. 6 
may be employed. The patient should be wrapped in warm dry 
blankets, and hot bricks, or bottles of hot watej*, covered with 
damp cloths, placed at the feet, and around tlie body, or the 
vapour bath applied. The body and limbs may be rubbed with 
the warm hand, or with dry flannels. Stimulants, such as pep- 
per sauce, or No. 6, should also be applied to the surface. The 



SUSPENDED ANIMATION. 271 

external beat must be applied gradualhj, as the ^^ inward beat" 
will be very much exhausted. The steam, however, may be of 
the usual temperature, by observing the precaution to wet the 
face and surface of the body frequently with cold spirits or vin- 
egar. 

Unless there is some degree of sensibility existing, it will be 
diSicultto introduce medicine into the stomach, except by means 
of the stomach-pump or catheter. In attempting to introduce a 
tube into the stomach, care will be iiecessai'y to avoid the wind- 
pipe : the jaws should be opened wide, the head turned back- 
wards, and the end of the tube placed against the back part of 
the throat, wiiich will direct it into the right channel. As soon 
as the tube is introduced, stimulants may be conveyed through 
it into the stomach. The third preparation of lobelia should be 
employed, if at hand ; or if not to be obtained, capsicum tea, No. 
6, or brandy, may be substituted. 

e 

Symptoms which accompamj returning animation, — Twitch- 
ings of tiie muscles about the mouth; soon followed by efforts to 
breathe; sudden motions of the limbs; *' a small and weak pulse, 
beating at irregular intervals; and a discharge of frothy fluid 
from the mouth." 

As soon as the patient can swallow, stimulants such as the 
third preparation of lobelia, or pepper tea, must be given in 
small doses, and these frequently repeated. 

Wine wliey and essence of beef, should be given as nourish- 
ment, and especial care should be taken to keep the patient com- 
fortably warm. Vomiting is often induced when animation is 
being restored, which is always a favourable symptom. 



SECTON II. 



Suspended animation from Carbonic dcid Gas. 

Carbonic Jlcid Gas, produced by burning charcoal, wiien tak° 
ing into the lungs undiluted with atmospheric air, will very 
quickly destroy life. The gas not only excludes oxygen from 
the lungs, which is necessary to life, but it exercises a deadly 
influence upon the nervous system, speedily destroying its sensi- 
bility. 

A person in a tight room where there is a furnace of burning 
charcoal, will soon become affected with s:iddiness and faintness; 



272 SUSPENDED ANIMATION. 

followed by stupour and insensibility, and unless carried into 
fresh air, life soon becomes extinct. Many deaths have been 
occasioned from sleeping in rooms in which charcoal was burn- 
ing, and where there were no means for the escape of the gas. 

Carbonic acid gas being heavier than atmospheric air, settles 
next the floor and fills the room from below upwards. Hence a 
person lying on the floor, would become affected by it, and sink 
into a state of insensibility; whilst another person occupying a 
position near the ceiling would be very little, if at all, affected 
by it. This affords an explanation why dogs and cats are sooner 
affected than men, in the same room — the animals inhaling the 
gas, whilst a man would be above it. 

Treatment — In suspended animation from the inhalation of 
carbonic acid gas, the patient must be removed immediately 
into a current of fresh air; and cold water dashed on the face and 
bueast. If the patient be entirely insensible, the clothing should 
be stripped from the body, and cold water dashed on the head 
and breast, or the head raised and a stream of cold water poured 
upon it. Sometimes the first dash of the cold water will occa- 
sion a convulsive effort to breathe. 

A stimulating injection should be administered as early as 
possible, and frequently repeated. The third preparation of lo- 
belia with luke-warm water, will form the most effectual injec- 
tion, and in the absence of this, some other stimulant, as com- 
position or pepper tea, wine, or vinegar and water. The sur- 
face of the body and limbs should be rubbed freely, and bathed 
with whiskey or vinegar, and if tlie patient can swallow, stimu- 
lants must be given in small doses and frequently repeated. 

When breathing becomes fully restored, the patient may be 
rubbed dry, and placed in bed, and should continue to take fre- 
quently of stimulants, such as, capsicum, composition, or wine 
whey, with carbonate of ammonia. If the patient has not vom- 
ited, the third preparation of lobelia may be given in bayberry 
tea, and the dose repeated until vomiting takes place. 

In some instances, after vitality is restored, vigorous reaction 
ensues: *^the heart palpitates vehemently; the pulse is full, 
strong, and hard; the vessels of the head turgid, and a disposi- 
tion to Ijeavy sleep ensues. Under these circumstances the third 
preparation of lobelia must be given freely, with a view to give 
the stomach power to regulate the circulation; and in order to 
place the system more fully under the influence of lobelia, injec- 
tions composed of lobelia powder in warm water must be admin- 
istered. The face and breast should be bathed with vinegar or 
spirits;,and warmth applied to the feet. 



Si^CTION III. 



Suspended Animation from Lightning* 

Persons struck by lightning require the same treatment as 
above directed : to dash bucketsfull of cold water over the face 
and breast, and to apply stimulating injections to the bowels, 
are the most important means for restoring animation. 

Case. — The following case is reported in the fifth volume of 
the Philadelphia Botanic Sentinel, by Dr. Imri Spruill, of North 
Carolina : ** Mr. Lewis Harrell was called last May to a negro 
woman who had been struck by lightning; and, said he, when I 
got there I saw about twenty men standing around a negro wo- 
man, who appeared to be (as it was thought by all) in the ago- 
nies of death, and speechless. Knowing tlie efficacy of the 
Thomsonian remedies, I gave her a large dose of the third pre- 
paration of lobelia, which soon aroused her, and enabled her to 
speak. On making an examination I found that the lightning 
had struck the back part of her head, and passed obliquely to 
the breast, tearing a new homespun cap up like gun wadding, 
and taking a strip of skin off in its way two inches wide, and 
extending over the breast and lower part of the abdomen to the 
groin, leaving a streak from the groin down to the sole of tlie 
foot. Her under garment was split throughout its entire length 
with as much precision as though it had been done with a knife. 
Two or three courses of medicine were administered, and she 
recovered rapidly. 



^fc 



CHAPTER XI. 
VARIOUS FORMS OF DISEASE OF THE EVES, 



SECTION I. 



Inflammation of the Eyes from taking Cold. 

When the eyes become inflamed by taking cold in them, 
the inflammation is usually in the membrane that covers the 
white of the eyes, and the inner surface of the eye-lids. The 
direct effect of cold upon the eye is to weaken and debilitate it; 
and the inflammation that ensues is an effort of nature to remove 
the effects produced by the cold. 

Sijmptoms.— These are a redness more or less extended over 
the white of the eyes; an appearance of inflammation on the un- 
der surface of the eye-lids; a feeling of sand in the eye; a profuse 
secretion of tears, and sometimes a thick matter in the cor- 
ners of the eyes, and about the eye-lashes, and a strong light is 
intolerably painful. 

Local Treatment. — In inflammation of the eyes proceeding from 
cold, all kinds of cold applications are to be avoided : for al- 
though they may afford temporary relief, they scarcely ever 
fail of exercising an injurious influence. It is in inflammation of 
the eyes, arising from wounds or bruises, that cold applications 
are sometimes found useful. Even physicians of the old school, 
deprecate the use of cold applications in that variety of inflam- 
mation of the eyes, which they term catarrhal ophthalmia. 

Moderately stimulating washes, and warm poultices may be 
employed with more advantage in all cases of inflammation of 
the eyes, arising from cold. 

Eye Washes. — In the early stages of the inflammation, ben- 
efit may be derived by washing the eyes occasionally with 
warm catnip tea, a weak infusion of lobelia, or even with a weak 
tea of capsicum. The object of stimulating washes is to increase 



DISEASE OF THE EYES. 275 

the secretions from the inflamed mucous membrane. It is in 
this way that stimulants lessen inflammation of the mucous 
membranes. The design of the inflammation is to restore the 
secretions, and hence the application of pure stimulants operates 
in harmony with the designs of nature. 

Astringent washes of every description are improper in the 
earlier stages of the inflammation, except there be a stimulous 
in the wash sufficient to overcome the drying effect of the astrin- 
gent. Astringent washes are applicable to chronic inflammation 
of the eyes. 

Poultices of elm, flaxseed, or indian mush, adding a small 
portion of ginger, applied to the eyes warm, and wet occasion- 
ally with warm catnip tea, or warm water, will prove service- 
able if not continued too long at a time. The constant applica- 
tion of a poultice for several days, would relax the parts so 
much that the cure might be retarded thereby. The poultice 
should be covered with gauze or book muslin to prevent its ad- 
hering to the eye. 

Constitutional Treatment, in inflammation of the eyes, is, in 
many instances, of greater importance than local applications. 
Inflammation of the eyes is generally associated with a disor- 
dered state of the system. The eyes being weakened by a 
weakened condition of the vital powers of the system, ai^e tlius 
predisposed to disease from the impression of cold, and when in- 
flammation comes on, tlie cure will be greatly facilitated by im- 
proving the condition of the general health, either by the use of 
pure stimulants — composition, capsicum, or simple herb teas, 
together with the use of the warm foot bath, and a careful avoid- 
ance of cold; or by a course of medicine, followed by the use of the 
stimulants above-mentioned, with a viev/ to promote perspiration, 
and sustain and strengthen the curative efforts of the constitu- 
tion. 

If there be violent pain in the head, injections should be used, 
containing a portion of lobelia; the feet kept warm, and broken 
doses of lobelia given in combination with the stimulants. 

Inflamed or sore eyes from dust, seldom require any other 
attention than to wash them with warm milk and water. 



SECTION II. 



Rheumatic Injlammation of the Eye, 

Tub globe of the eye, except the transparent portion in front, 
containing the pupil, and an opening on the back part, for the 
passage of the optic nerve, is covered by a membrane of a fibrous 
structure, similar to the tendons of muscles and ligaments about 
the joints. It is inflammation of this fibrous structure that con- 
stitutes rheumatism. When the fibrous membrane of the eye 
becomes inflamed, it is attended with pain which resembles 
rheumatic pains, and hence it is termed rheumatic ophthalmia. 
The difference therefore between catarrhal ophthalmia and rheum- 
atic ophthlamiaf is the difference in the location of the disease: 
in the first, the inflammation is seated in the mucous mem- 
brane of the eye — in the latter, the inflammation is seated in a 
fibrous membrane, beneath the mucous membrane. 

Stjmptoms. — These are violent pain in the ball of the eye, 
<* extending to the temples, teeth, lower jaw, and internal ear. 
The pain is continuous, with occasional fits of aggravation, and 
is almost always much more severe at night than during the day. 
The white of the eye is of a yellowish-red tinge, terminating ab- 
ruptly at tlie cornea — which latter (the transparent part of the 
centre of the eye ball) becomes dull, cloudy, and, as the disease 
advances, more opaque in the centre than at thecircumferance." 
"The flow of tears is at first diminished, but in the course of the 
disease, it becomes copious. 

Causes. — Rheumatic inflammation of the eye is generally 
brought on by exposure to cold and dampness. More especially 
is it apt to occur from exposure to cold when the system is un- 
der the influence of mercury. 

Treatment. — Constitutional treatment is necessary in most 
cases of rheumatic inflammation of the eye. The means to be 
employed are such as will restore the natural warmth of the sys- 
tem, cleanse the stomach and bowels, promote perspiration and 
restore digestion. 

First give stimulants, composition, or capsicum tea, and if 
the pain be severe, attended with an undue determination of 
blood to the head, the feet must be placed occasionally in warm 



DISEASE OF THE EYES. Q77 

water, containing a portion of mustard; and stimulating injec- 
tions containing a portion of lobelia, administered once or twice 
a day, and the patient kept warmly covered to favour perspira- 
tion. If this course of treatment prove insufficient to relieve 
the pain, a course of medicine must be given and repeated ac- 
cording to the urgency of the symptoms. 

The compound lobelia pills if taken in doses of two or three 
pills every two hours, will not only afford sufficient stimulous 
in ordinary cases, but by them the system is brought under the 
continued influence of lobelia, which is of the highest importance, 
more especially in the earlier stages of the disease. 

"When the disease becomes chronic, which means that it be- 
comes protracted and unaccompanied with fever, or other symp- 
toms of reaction, gum guiacum, and bitter tonics, are to be em- 
ployed, together with the general course of treatment above re- 
commended. 

Local Applications — In the early stages of the disease when 
the secretions of the eye are deficient, and the pain in the eye 
severe, moderately stimulating applications, either in the form 
of poultices or washes, are indicated for the purpose of restoring 
the secretions of the eye. A weak infusion or diluted tincture 
of lobelia, or weak capsicum tea, may be used for this purpose, 
and the same kind of poultice applied as recommended in ca- 
tarrhal oplithalmia. 



SECTION III. 



Suppurative Inflammation of the Eijes. 

Symptoms. — This variety of disease of the eyes is marked 
by a sudden swelling of the eye-lids, attended with a copious 
discharge of a thick white or yellowish matter. In severe cases 
the eye-lids become enormously swollen, more especially the up- 
per lid. Tliere is more or less pain in the eyes, even in the 
milder form of the disease, and where the swelling is very great, 
the attending pain is usually violent. The mucous membrane 
covering the eye-ball becomes also much swollen, rising up like 
a spongy mass, and sometimes overlapping the pupil. A copi- 
ous secretion of pus takes place soon after the swelling com- 
mences, though sometimes the matter does not escape, as it is 
formed, in consequence of the swelling, causing the eye-lids to 



278 DISEASE OE THE EYES. 

be firmly closed. The pus being thus retained, distends the eye- 
lids in the form of a round fluctuating tumour, the contents of 
which, sooner or later, escape from between the eye-lids. In 
the severe form of the disease, there is always considerable con- 
stitutional disorder and generally high fever at niglit. 

Under a proper course of treatment the symptoms, even in 
this severe form of the disease will generally begin to moderate 
ij» the course of a few days, and the eye gradually recover, and 
become restored to a healtliy condition. Occasionally, however, 
the ball of the eye suppurates, partially or wholly destroying the 
sight. 

Infants are occasionally attacked with sudden swelling and 
inflammation of the eyes, attended by a free discharge of mat- 
ter. In them the disease \ery rarely injures the eyes perma- 
nently. 

A very destructive form of disease of the eye prevailed epidem- 
ically, and to a great extent, in Egypt, ^^ during the British ex- 
pedition under Sir Ralph Abercromhy." This disease received 
the name of Egyptian opthalmia. 

Causes — The Egyptian opthalmia was supposed to be caused 
by a suddenly variable temperature — an atmosphere loaded with 
dampness and humidity, by the prevalence of a **hot wind loaded 
with fine particles of sand, and a bright and piercing light of the 
sun. Another and more frequent cause of the disease in this coun- 
try is the accidental application of certain poisonous substances to 
the eye, more e.specially the matter from the venereal disease. 

The disease, as it occurs in infants soon after birth, is occa- 
sioned by some morbid secretion being introduced into tlie eye 
at the time of the infant's birth. On this subject Dr. Eberle ob- 
serves, ** I have never known a single instance of this disease 
occurring in infants soon after birth, when, upon inquiry, I did 
not learn that the mother had been aff'ected with leucorrlioea, or 
some other morbid vaginal secretion." 

Of the Consequences of this form of Disease. —As it occurred 
epidemically in Egyjjt at the time above mentioned, the disease 
proved very destructive to the eyes. The introduction of the 
matter of the venereal disease into the eye sometimes occasions 
a loss of its sight, and this form of disease is always difiicult to 
cure. As the disease occurs in young infants it is seldom fol- 
lowed by serious injury of the eye, the matter occasioning the 
disease being of a less destructive nature than that of gonorrhosal 
poison. A mild form of suppurative inflammation of the eye is 
sometimes occasioned by constitutional disorder, and also from 
ordinary atmospheric influences, but which seldom or never oc- 
casion any serious injury to the eye. 



DISEASE OF THE ETES. 279 

Treatment — In all violent attacks of suppurative inflamma- 
tion of the eye, a vigorous course of constitutional treatment is 
imperiously demanded. The patient should have a tliorougli 
course of medicine administered early, and the same repeated 
daily, until the disease begins to decline. If it should be incon- 
venient to administer a regular course of medicine, the warm 
foot bath must be used, and composition or cayenne pepper tea 
given freely: after this an emetic must be given, and if the symp- 
toms continue to be of a violent character, doses of lobelia in 
composition tea, must be continued every hour or two; stimu- 
lating injections administered three or four times a day; hot 
bricks wTapped in damp cloths placed at the feet; and the 
head kept elevated by pillows. If there be high fever, with vio- 
lent pain in the head and eyes, benefit will be derived by admin- 
istering a small teaspoonful of lobelia powder in luke-warm 
water, by injection, and retained. This will relax the system, 
and generally cause the patient to vomit, from w hich he will in- 
variably obtain more or less relief from his suiferings. 

When the disease is of a mild form, and also when it is on the 
decline, a less energetic treatment will be required — merely 
giving occasionally composition, ginger, or pennyroyal tea, 
to favour a determination to the surface, and warm applications 
to the feet. In all cases, however, Avhen the eyes are very much 
swollen, the system must be placed under the influence of lobelia, 
and continued in a state of moderate relaxation, more particu- 
larly during the early stages of the disease. 

In infants constitutional treatment is seldom necessary, unless 
the disease of the eyes be brought on by a disordered condition 
of the stomach and bowels. If the bowels be disordered, injec- 
tions must be administered. These may be prepared of simple 
bayberry tea, adding half a teaspoonful of the tincture of lobelia 
to each injection, and the same given by the mouth in small doses: 
a teaspoonful of bayberry tea with four or five drops of the tinc- 
ture of lobelia, repeated four or five times a day. 

Local Jlpplications. — As the disease occurs in infants, I have 
found a weak infusion of lobelia, combined with raspberry tea, 
to be an effectual application. The eyes to be washed occasion- 
ally with the above tea, warm. All cold applications are inju- 
rious. It may be necessary, in some instances, even in infants, 
to apply a warm emollient poultice. Slippery elm powder, white 
pond lily, and crackers rolled fine, with a small portion of ginger, 
forms a suitable compound for a poultice, which should be wet 
with warm water. 

The same local applications, viz: lobelia and raspberry tea, 
and warm poultices, will be proper in the early stages of the 
same disease, without regard to the age of the patient, or the 



280 DISEASE or THE EYES. 

cause of the disorder. In a later period of the disease, in adults, 
when the swelling has suhsided, and the eye-lids are in a relaxed 
condition, Dr. Thomson's eye-water, simple tincture of myrrh, 
a tincture of myrrh and bayberry, or No. 6, will be suitable ap- 
plications. When the disease has been produced by the appli- 
cation of venereal poison, the eyes should be frequently w^ashed 
with a strong infusion or tincture of lobelia. 

In all cases where the disease has become protracted, and the 
patient is in a feeble condition, tonics, such as quassia, worm- 
wood, Peruvian bark, Virginia snake root, gentian, &c., must 
be given, together with stimulants and nourishing food, in order 
to excite and sustain the curative efforts of nature. 



SECTION IV. 



SCROFULOUS SORE EYES. 

In this variety of disease of the eyes, the inflammation is 
mostly confined to the margins of the eye-lids, attended with 
extreme sensibity to light, a profuse secretion of tears, and a 
thick matter exuding from the edges of the eye- lids and the 
roots of the eye-lashes, which glues the lids together during 
sleep. 

This form of disease prevails most in childhood, occurring 
in those of delicate constitution. Sometimes the eyes become 
diseased from want of cleanliness alone. 

In some cases the patient cannot bear the light to come to the 
eyes, he keeps them constantly closed, places his hands over 
them, and lies with his face downward. 

Scrofulous disease of the eye is generally protracted in dura- 
tion — in many instances continuing with a greater or less degree 
of severity many months or even years, until by the aid of medi- 
cine, and other means, or by the natural increase of strength, 
the constitutional powers are invigorated and the disease there- 
by removed. 

Treatment, — Scrofulous sore eyes, being a constitutional dis- 
ease, depending upon a feeble organization, not only demands 
constitutwnal treatment, but in the great majority of cases, re- 
quires a considerable period of time to effect a permanent cure. 
In general, much medicine will not be required. Exercise in 
the open air, wholesome nourishing food, warm clothing, keep- 



DISEASE OE THE EYES. 281 

ing the feet dry and warm, cleanliness, a cold shower bath or 
sponging the body with saltwater in the morning, and frictions 
of the surface with the flesh brusli or salted towel, are important 
means for improving the general health, and strengthening the 
constitution. 

When the appetite is bad, the breath offensive, or the stools 
exhibit an nnhealtliy appearance, an emetic will be beneficial: 
this will operate still more effectually after the administration 
of a vapour bath. In recent cases the operation of an emetic 
will generally be followed by a manifest improvement in the 
condition of the eyes, and sometimes it alone will effect a cure. 

The Compound Lobelia Fills may be used with benefit in al- 
most all cases of chronic disease, whether it be of a scrofulous 
character or otherwise. These pills do not affect tlie bowels in 
the way that cathartics operate; they stimulate the peristaltic 
action of the bowels, and excite the secretions of their mucous 
membrane without disordering the functions of the bowels, or 
weakening the vital powers ; whereas cathartics disorder the 
stomach, and weaken the functions of the bowels. The contin- 
ued use of a cathartic— for instance, a small dose of Epsom or 
Glauber salts, taken daily, or every few days, by provoking 
irritation in the bowels, and lessening the determination of blood 
to the surface, may diminish the inflammation of the eyes; but 
the constitutional disorder will be increased, because digestion 
must necessarily be impaired, by the action of the salts — they 
merely changing the symptoms of the disease without restoring the 
health. Let a child in good health be purged with salts every day, 
and this continued for a week, the digestive powers at the end of 
the week will be impaired, the warmth of the system w ill be re- 
duced, and the bowels will remain enfeebled and inactive for 
several days after. The absurdity of administering such medicine 
to one whose constitution is feeble, and tlie general health de- 
ranged must be apparent to every unprejudiced mind. To 
change the symptoms of disease by the use of cathartics, or by 
administering poisons, is one thing, but to remove disease from 
the system, is quite a different matter. 

Purijied Charcoal may be used with advantage in cases of cos- 
tiveness, more particularly when accompanied with an acid con- 
dition of the stomach. The dose is a teaspoonful two or three 
times a day, taken before meals. 

Salt and Vinegar, — When patients have an inclination for 
acids, such as vinegar, or lemon juice, as they frequently have 
in scrofulous complaints, where digestion is impaired, a mixture 
of salt and vinegar will sometimes be found of signal benefit in 
improving digestion. 

Qh 



282 DISEASE OF THE EYES. 

Tonics must be given wlien the patient is in a feeLIe and re- 
laxed condition- Spice bitters are proper to be given during 
any period of scrofula: they may be given both as a mild tonic, 
and a stimulant, supplying the place of stronger stimulants and 
tonics, in milder cases of the disease. 

Sarsaparilla, — A simple syrup of this article is an admirable 
medicine for scrofula in certain conditions of the system. I 
have occasionally observed the most marked benefit from its use 
in cases where the disease had apparently come to a crisis, the 
patient remaining in a weak and languid condition. Sut whether 
the patient be most benefited by the sarsaparilla or by the syrup 
of sugar, is not very easy to decide. 

Local Tretitmeni. — In scrofulous sore eyes, it will be found ou 
examination that some of the eye-lashes are dead, and thus oper- 
ating as foreign bodies to the parts, occasion very disagreeable 
itching in the eye-lids, and the formation of matter at their 
roots. The removal of these dead eye-lashes, therefore, is im- 
portant in the cure of the disease. A little observation will 
teach one how to distinguish the living from the dead lashes, and 
they are very easily removed, without pain, by a pair of tweez- 
ers. I have, on several occasions removed, at one time, over 
one hundred dead eye-iashes from the eye-lids of a patient af- 
fected with sore eyes; and sometimes this is all that is required 
in the way of treatment; ihe eyes becoming well soon after. 
In scrofulous constitutions, however, the disease of the eyes will 
rarely be radically removed until the general health be restored^ 
or at least manifestly improved. 

Astringent and stimulating washes may be used with more or 
less benefit in sore eyes of long continuance. The preparation 
called Thomson's eye w^ater, may be employed. Where the 
sensibility of the eye is very acute, this eye- water may be modi- 
fied by a teaspoonful of strong tea made of witch-hazle leaves^ 
or poplar bark, added to a teaspoonful of the eye-water. 

The diet must be light yet nourishing; fresh beef and mutton? 
poultry, wild game in season, eggs, boiled rice and milk, boiled 
milk and toast, toast and cream custard, stale bread and butter, 
black tea, chocolate, and all wholesome vegetables may be used; 
provided they be found to agree with the stomach. 

When scrofulous sore eyes are accompanied with eruptions on 
the face, or running sores behind the ears, the treatment should 
be the same as already described, observing especial care when 
vapour is administered to protect the skin surrounding the af- 
fected parts from tlie irritating secretions which the steam will 
cause to be discharged from the eruptions. The secretions from 



DISEASE OE THE EYES. '^^ ' 283 

sucli eruptions sometimes accompanying scrofulous sore eyes, 
are so acrid tliat they produce an eruption on the surrounding 
parts wherever they are touched by them, and in this way the 
disease will spread over almost the whole of the face and some- 
times extend from behind the ears down to the slioulders, and 
cover a portion of the back. This may in general be prevented 
by bathing the parts surrounding the eruption with No. 6, or the 
tincture of lobelia, immediately after the bath, the parts being 
protected at other times when the eruptions are discharged. 
These eruptions require the same plan of treatment recom- 
mended for tlie cure of scald-head, namely: to prevent the 
admission of air to the eruption by the application of salve or 
ointment, together with the use of medicines for correcting the 
general health. 

Case. — A little boy, living in Christian street, was affected 
with scrofulous sore eyes, attended with eruptions over the face 
and back of the ears, and after the disease had continued more 
than eighteen months, the patient was placed under Thomsonian 
treatment, which speedily improved the general health, but the 
eruptions suppurated freely, causing extensive patches of raw 
surface secreting pus. Necessary care was not taken for pre- 
venting the discharge from affecting the surrounding parts, and 
the disease consequently commenced spreading considerably. — 
The parents became discouraged, and applied again to the old 
practice. The treatment next pursued consisted in the con- 
tinued use of salts, and cooling applications to the surface. — 
Under this course of treatment the determination of blood to the 
surface was lessened, the system became cold and inactive, and 
as the disease left the face, the hip and knee became affected 
with scrofula, attended with years of suffering, and followed by 
distortion of the limb. Is it not probable that the cooling treat- 
ment occasioned the disease to become fixed in the hip, which 
would have been kept on the surface and eventually cured under 
Thomsonian treatment, and the disease thus prevented from 
seating itself in the hip? 



SECTION V. 



BLINDNESS. 

(total oil PASTIAL.) 



A TOTAL or partial loss of sight is caused by a variety of 
forms of disease of the eye, or more properly, different parts of 
the eye are liable to become diseased, occasioning loss of vision. 
Thus blindness may be produced by disease of the optic nerve, 
which conveys impressions to the brain. This form of disease 
is called amaurosis. 

A very common cause of blindness is an opacity of the crys- 
talline lens, or its capsule, designated by the term cataract 

Sometimes a total or partial loss of vision depends upon dis- 
ease of the transparent cornea of the eye, which is liable to be- 
come clouded and thickened; and occasionally it becomes very 
much swollen, bulging out from the centre of the eye-ball, form- 
ing a tumour as large as a cherry. The eye is also liable to 
dropsy, cancer, and to gangrenous ulceration; which happily, 
however, are of very rare occurrence. 

Symptoms of Amaurosis — Disease of the JYerve of the Eye. — In 
this form of disease the eye does not present any particular ap- 
pearance of disease upon a superficial examination, except that 
the expression is vacant, but on a closer inspectetion we find the 
pupil dilated, and on applying a lighted candle near, the con- 
tracting power of the pupil is observed to be either lost, or 
greatly diminished. ** There is frequently the sensation as if 
a cloud were before the eye," and the pupil often presents a 
greenish appearance. The sight is obscure, or the power of see- 
ing is lost. 

Causes. — Close and long continued application of the eyes to 
minute objects, more especially by candlelight; paralysis of the 
optic nerve from disease of the brain, or from constitutional dis- 
order, is the usual cause of amaurosis. 

Treatment — Almost the only hope in cases of amaurosis, is an 
early and vigorous course of constitutional treatment, with a 
view to restore the circulation of nervous fluid in the diseased 
nerve. Frequently, however, the disease depends upon causes 



DISEASE OF THE EYES. 285 

that render all medical means abortive; still a trial should be 
made as by it the sight may possibly be restored, or at least 
greatly improved. Many cases have been cured by the use of 
emeties. 

When amaurosis is connected with manifest derangement of 
the general health, there is stronger reason to anticipate benefit 
from the operation of emetics, but still more from full courses of 
medicine. 

Besides constitutional treatment, stimulating washes should 
be frequently applied to the eye, such as capsicum tea, or Thom- 
son's eye water, and the patient continue as much as possible in 
the light. The frequent application of volatile salts to the nose, 
and snuffing freely of composition or other stimulating powder, 
may assist in restoring the function of the optic nerve. 

Cases of amaurosis have been cured by the application of elec° 
tricity and galvanism. 

Concerning the Treatment of Cataract little need be said here, 
as the disease is one which requires an operation by the hands 
of a surgeon. In the incipient stage of cataract, however, a pro- 
per course of constitutional treatment may in some cases pre- 
vent the further progress of the disease, and even cause the ab- 
sorption of the cataract. The constitutional treatment for cat- 
aract does not differ from that recommended in amaurosis. 



SEGTO]>r VI. 



STYE. 



The formation of a small abscess on the eye-lid, called a stye^, 
is of very frequent occurrence. It is generally occasioned by a 
disordered condition of the stomach. Sometimes it is caused by 
the presence of a dead eye-lash, the abscess being found at the 
root of it. 

Treatment, — When the stye becomes painful and considerably 
inflamed, cooling applications should be made to the eye — fre- 
quently wetting the eye with cold water, or applying a poultice 
of slippery elm, or of flaxseed stewed with Indian meal, until it 
becomes well softened. If there be a dead eye-lash in the cen- 
tre of the stye, it should be pulled out, which sometimes, wlieo 



286 DISEASE OF THE EYES. 

done early, will check tlie further progress of the ahscess. Riih- 
Ling the stye, when it first appears, with cold metal, a silver 
spoon or knife hlade will, it is said, prevent an abscess from be- 
ing formed in many instances. 



SECTION VII. 



FISTULA LACRYMALIS. 



(^Obstruction of the duct which convetjs the tears from the eye into 

the nostril,^ 

The tears and mucus secreted in the eye are conveyed into 
the nostril through a small duct, which is liable to become ob- 
structed by various causes, and then the tears instead of passing 
Into the nose, are obliged to flow over the cheeks, proving a 
source of extreme annoyance. 

The obstruction may take place at the inner corner of the eye, 
where the duct C(mimences, and may be remedied by the careful 
introduction of a fine silver or gold pin through the duct into 
the lachrymal sac, which is an enlargement of the duct about a 
quarter of an inch from its commencement. If the obstruction 
be seated in the duct below this little sac or bag just alluded 
to, the tears will pass down into the sac, and being retained 
there in consequence of the obstruction below, it becomes swol- 
len into a round tumour as large sometimes as a chesnut. The 
tumour will be situated a short distance below the eye near its 
inner corner. By pressing upon the tumour the contents will 
be forced upwards and pass out at the eye, or if the obstruc- 
tion below the tumour be not complete, the tears contained 
in the sac may be forced into the nostril. ^^The complaint 
sometimes remains in this state for years, with little incon- 
venience, pressure being occasionally made upon the sac to 
empty it." Sometimes the tumour suppurates and breaks'ex- 
ternally, and the tears will pass out through this opening, and 
flow over the cheek. The sac is now very liable to frequent 
attacks of inflammation and suppuration. 

Treatment. — In the early stage of this complaint, constitu- 
tional treatment, particularly the vapour bath witli an emetic, 



DISEASE OF THE EYES. 2ST 

have ill some instances overcome the obstruction and effected a 
permanent cure. The disease, however, is seldom curable by 
constitutional treatment — the only chance of success by it is in 
the early stage, and especially when the obstruction is owing to 
inflammation and swelling of the duct. When these exist the 
use of the vapour bath, together with relaxing the system fully 
by lobelia, and promoting perspiration and an equal circulation 
by the use of stimulants, such as capsicum or composition, may 
prove successful in restoring the duct to a healthy condition. 

When tl\p tears flow over the cheek, and the lachrymal sac, 
just below the eye, is not swollen, it affords evidence that the 
obstruction is in the duct between the eye-lid and the laclirymal 
sac. This obstruction may be removed by passing a small sil- 
ver or gold pin down the duct into the sac. 

Sometimes the lachrymal sac becomes diseased, and secretes 
from its surface a thick matter which does not pass readily 
through the duct, and the sac becomes distended, requiring to be 
pressed upon in order to force the thick matter up to the corner 
of the eye, or down into the nose. 

A gentleman not long since told me that he was cured of an 
obstruction in the duct that leads the tears into the nose, by the 
operation of a course of medicine. The disease had continued 
for many months, the tears passing over the cheek. During 
the operation of the emetic the tears resumed their natural chan- 
nel by the removal of the obstruction in the duct. It is not to 
be inferred, however, that many cases of this affection can be 
removed by a course of medicine. It is only under particular 
circumstances that we can reasonably anticipate a cure by con- 
stitutional treatment. 

A common practice in this complaint is to introduce a gold or 
{Silver tube down the course of the duct, and thus lead the tears 
into the nostrils. In some cases this tube answers a good pur- 
pose — in others it does injury. 



CHAPTER XIL 



SECTION I. 



Insanity depends upon a diseased condition of the hrain, 
which is the organ of the mind. 

<^The mind consists of a plurality of innato and independent 
faculties, a congregation of separate and primary powers." — 
(^Fowler,) Each f^iculty of the mind has its especial organ, and 
^ wlien only a part of the hrain is diseased, those faculties only 
Avill he deranged or destroyed which are located in the diseased 
part. Thus the doctrines of phrenology explain the reason why 
an individual may be insane on some subjects, and at the same 
time quite rational on others. 

There is a close and intimate sympathy existing between the 
mind and the body, so that a change in the condition of the one 
will vary the condition of the other. Who has ever experienced 
a flow of good spirits during a fit of ague, or in the commencing 
stage of small-pox, or in the early stage of any other form of 
disease, when the brain is deprived of its due supply of blood 
and nervous energy. In proportion as the nervous energy of the 
brain is enfeebled, and the supply of arterial blood to it lessened, 
so in proportion will the mind become enfeebled — it cannot be 
otherwise — yet still the mind may be free from insanity. Cases 
occur, liowever, where the brain receives so small a supply of 
arterial blood, in consequence probably of long continued inve- 
terate dyspepsia, that it does not generate a sufficient quan- 
tity of nervous fluid to support the mind, and consequently 
it sinks into a state of imbecility, and sometimes into insanity. 
A blow upon the head, producing concussion of the brain, stops 
at once the operation of the mind until the brain recover from 
the shock. And again, sudden impressions made upon the mind 
exert a powerful influence upon the brain and digestive organs. 



INSAXITY. 289 

Too close attention to stu{l3% immediately after dinner, weakens 
digestion by causing an afflux of nervous energy to the brain, 
and thus determining it from the stomach, enfeebles digestion. 
A sudden shock of the mind soon after a meal, such as sud- 
den fright or some distressing news, will sus])end the power of 
digestion. This intimate connexion existing between the mind 
and the body leads us to perceive the cause of mental derange- 
ment in the diseased condition of the organs of the mind. 

Causes. — In some families tliere exists a predisposition to in- 
sanity, so t!iat several members of the same family will be af- 
fected with the disease. 

Moral influences by disordering the organs of the mind, occa- 
sion insanity. Thus, by close, long continued, and deep study, 
the blood vessels of the brain may become diseased, and so far 
derange the functions of the brain as to occasion insanity. A 
great variety of moral inHuences, — disappointed love, religious 
enthusiasm, fanaticism, excessive joy, jealousy, and long con- 
tinued depression of mind, sometimes produce insanity. 

Fhijsical causes. — These are excessive losses of blood, exhaus- 
tion from long continued, inveterate dyspepsia, habitual drunk- 
enness, injuries of the head, abscess in the brain, the inordinate 
use of mercury, the use of narcotic poisons, and a diseased con- 
dition of the stomach and bowels. Some of the early writers on 
medicine have maintained that mental derangement has its seat 
in the stomach — the diseased condition of the functions of tlie 
brain being the consequence of a disordered condition of the sto- 
mach. 

Chances of cure. — Of the cases of insanity that occur, probably 
less than one half are cured. The great majority of cures take 
place within the first year from the commencement of the dis- 
ease. After the disease has continued without intermission over 
three years, there is little hope of the patient being restored to 
perfect reason; still recoveries sometimes take place after tlie 
fifth or sixtli year from the commencement of the derangement. 

It is stated by physicians who have attended in lunatic asylumsp 
that partial insanity and melanchohj^ are more difUcuit to cure 
than a general derangement of the mental faculties unattended 
with melancholy. It is also ascertained that patients who have a 
distinct recollection of recent occurrences, ^*with an oblivion of 
events long passed," are more easily cured, than those who have 
a recollection of events long past, but who cannot remember oc- 
currences tliat have recently transpired about them. ** In gene- 

2 M 



290 MANIA. 

ral, acute and furious mania is much more under tlie control of 
ixmedial management than low, torpid, and fatuous insanity. 
Mental derangement from physical causes, generally yield more 
readily and permanently than w hen it arises from moral causes. 
A recovery of the general health of the system, without a cor- 
responding melioration of the mental disease, is said to be an 
unfavourable sign." {Eherle.^ 



1. MANIA GENERAL INSANITY. 

Symptoms which characterize general Mental Berangement, or 
Mania, — These are a rapid succession of incoherent ideas, and 
violent excitement of the passions, expressed by great agitation, 
loud vociferation, singing, menaces, and fury. 

Torpor of the bowels, cold extremities, variable appetite fre- 
quently craving, sudden and frequent variations of temper, the 
patient often manifesting a vicious disposition, an inability to 
sleep much, and frightful and distressing dreams, are symptoms 
which generally precede the occurrence of mania. 

"When the disease is once fully developed, the expression of 
the countenance is wild, and often furious; the eyes are promi- 
nent, sparkling, and in constant motion; the patient sings, 
whistles, vociferates, halloos, walks too and fro with rapidity, 
or stands still with his hands and eyes often raised towards the 
heavens; he does not sleep for many nights, sometimes not for 
several weeks; he often manifests great muscular power; the 
skin is dry, cool, and occasionally covered with profuse perspi- 
ration."' It is stated that the exhalation of a peculiar and disa- 
greeable odour from the body, and excretions is peculiar to ma- 
niacs. 

'* In the violent grades of mania, the mind forms erroneous 
perceptions of the impression of external objects on the senses, 
or the senses convey erroneous impressions to the mind. In this 
case the patient does not recognize the persons and objects 
around him ; mistakes friends for strangers, and commonly vis- 
itors for his relations, loses the consciousness of his individuality, 
and is ignorant of the place he occupies, of his rank and condi- 
tion in society, and of the lapse of time. The imagination is 
sometimes so powerfully excited, tliat its representatives prevail 
over those of the senses. The patient hears voices, holds conver- 
sations with persons whom he imagines are present, and in some 
cases these -voices harass him wherever he goes, by day and by 
night, in public and in private. Sometimes the empire of voli- 
tion seems to be entirely suspended, and the patient is no longer 



MANIA. 291 

master of his own determinations. An irresistible impulse leads 
him to injure himself^ or to iniiict injury upon others, to tear 
the clothes from his body, run out naked into the streets, leap 
out of the windows, and to commit other acts of fury.'' 



2. PARTI Ali IX SAN ITT. 

In this form of mental derangement a part of the organs of 
the faculties, or of a single faculty of the mind, only, is dis- 
eased so that the patient will be insane upon one subject and en- 
tirely rational on others. 

" This is by far the most common form of mental derange- 
ment, and it is always entirely free from delirium or paroxysmal 
raving." 

In that variety which is usually (\enomm?ite6.' hypochondriasis, 
the hallucinations relate to the patient's own body, or to the 
circumstances which he conceives have an especial sinister in- 
fluence upon his own sijstem, fortune, or happiness. -■ The sug- 
gestions of his morbid imagination are taken for realities. He 
believes himself afflicted with some certain incurable and fatal 
disease, particularly with consumption, cancer, or stone, and 
above all, with impotency and the venereal disease. He fancies 
that some poison has been maliciously introduced into his system; 
or that he has a living animal, or some other very injurious sub- 
stance in his stomach or bowels. Some patients believe them- 
selves transformed into inferior animals," and others imagine 
themselves to be made of glass, wax, butter, &c. 

Unnumbered throngs on every side are seen. 
Of bodies changed by various forms of spleen. 
Here living tea-pots stand, one arm held out, 
One bent; the handle this, and that the spout; 
Ji pipkin there, like Homer^s tripod walks. 
Here sighs ajar, and there a goose-pie talks. 
Men prove with child, as powerful fancy works, 
And maids turned bottles, cry aloud for corks. 

Pope. 

Some patients are insane on the subject of religion; others 
upon the subject of love, wealth, or ambition. I knew a minis- 
ter, a member of the society of Friends, who visited England 
and returned again entirely insane on the subject of religion, 
but was perfectly sane on other subjects. 



29£ PAr^TIAIi INSANITY. 

Treatment of Mental Disease, 

Tlie medical profession have almost abandoned the use of 
medicine in the treatment of insanity, depending almost exclu- 
sively upon moral influences — a removal of the patient from home, 
and kind treatment, are the means chiefly relied upon by those 
who have had long experience in treating mental disease. 

From the good success that has attended Thomsonian treat- 
ment irs several cases of insanity that have come to my know- 
ledge, I cannot entertain a doubt that many, very many cases of 
insanity, depending upon a disordered condition of the stomach, 
or upon a diseased state of the system generally, may be cured 
by that system of practice. The failure of the old school prac- 
tice of medicine furnishes no just criterion to judge of the effects 
of Thomsonian treatment. A patient may have taken emetics 
of tartarized antimony, without being benefited, and yet be 
greatly benefited by a Thomsonian course of medicine. Mer- 
curial preparations, cathartics, cupping, leeching, together 
with the use of all tlie remedies which are employed by the med- 
ical profession for reducing what they call morbid excitement, 
may fail of doing good, when an opposite and more rational 
course of treatment may prove successful in removing the dis- 
ease, by aiding nature. 

Cflse. — 'I attended a female last winter who had become insane 
through religions enthusiasm. She had been in feeble health for 
many years. On my first visit I found her uuder the bed, and 
when brought from her hiding place, she manifested a high de- 
gree of mental excitement, frequently bursting forth in a contin- 
ued and rapid strain of imprecations and curses, until she became 
exhausted, when she would lie down for a time and sometimes 
hide her head under the pillow, or throw her limbs about as 
though suffering bodily distress. In this case I found the most 
signal benefit from giving lobelia emetics. Every time she 
vomited freely, and the system became relaxed under the influence 
of the lobelia, she became quiet and would sleep several hours. 
Under this treatment, namely, an emetic given at intervals of 
one or two days, and broken doses of lobelia given at intervals 
of every two or three hours, as the patient could be persuaded to 
take them, not resorting at any time to compulsory means except 
the patient made an attempt to go out of the room. During the 
operation of the fourth or fifth emetic a large mass of thick dark 
green matter was thrown from the stomach, the muscular system 
became fuHy relaxed, the patient continuing many hours very 
sick and mucli distressed, after which she became calm and com- 
posed and had no return of insanity except in a very slight de- 
gree. 



PARTIAL INSANITY. 293 

III Another Case of Mental Derangement occurring in a young 
man, of this city, medicine appeared to have scarcely any appre- 
ciable effect on the disease. The derangement had approached 
in a gradual manner, his family and friends having frequently 
observed him to be absent minded, and occasionally disposed to 
melancholy, secluding himself from the society of his own fami- 
ly ; and then again to form some scheme for regenerating the 
world, or to attempt to engage in some wild speculation. This 
condition of mind continued several years before he became en- 
tirely insane. Although medical treatment appeared to have 
scarcely any effect, yet under kind treatment from his family tlie 
mental derangement improved so that he was removed to tlie fa- 
mily of a friend, and from that time he began to recover more 
rapidly, until all the symptoms of insanity disappeared. 

When the insanity is general, and comes on suddenly, attend- 
ed with great excitement and even furious delirium, it is in gen- 
eral much more under the control of medical treatment, than 
when it is accompanied with melancholy and a torpid condition 
of the system, or when the case is one of partial insanity. 

*^ One of the first measures in the treatment of mania, should 
be to remove the patient from his friends and home, and to place 
him in some quiet and secluded situation. Dr. Rush strongly 
insists upon the importance of separation and proper seclusion ; 
and the most eminent of the English, German, and Frencli wri- 
ters, advise the adoption of tliis measure." ^' Let it be observed, 
however, that in recommending separation and confinement, it is 
not intended to object to regular exercise in the open air, and 
the enjoyment of the society of suitable persons during the pa- 
tient's intervals of comparative calnmess. Whenever the weath- 
er is favourable, and the patient's condition will admit of it, free 
air and ample exercise sliould be allowed. The mutual associ- 
ation of patients similarly affected, and particularly during con- 
valescence, has also a favourable tendency," 

Idleness is unfavourable to the recovery of patients affected 
with 'partial insanity ; they should be allowed, and even persua- 
ded to engage in amusing exercises, **as playing at quoits, the 
clmse, shooting, and even chess, checkers, cards, and push-pin; 
should be preferred to idleness." (^RusJu) 

The Medical Treai?ne?if generally pursued in the different asy- 
lums, and hospitals for the insane, is tlie chief objection to these 
institutions. Established for the purposes of benevolence and 
philanthropy, and under the government of persons experienced 
in the management of the unfortunate insane, and with the ad- 
vantages wliich they afford in relation to discipline, exercise and 
amusement, these institutions, apart from the medical treatment 



594 PARTIAL INSANITY. 

practised upon the patients, should receive the sanction and sup- 
port of every member of the community. 

"In the furious state, insane patients should never be contra- 
dicted, however absurd their opinions and assertions may be, 
nor should we by our answers deny their requests, when it is 
proper to grant them. In the second grade of the disease, we 
should divert them from the subjects upon which they are de- 
ranged, and introduce as it were accidentally, subjects of another 
and of an agreeable nature. When they are upon the recovery, 
we may oppose their opinions and incoherent tales, by reasoning, 
contradiction, and even ridicule." {Rush.^ 

When insanity is brought on by the sudden suppression of the 
catimenia from cold, the treatment must be directed to the re- 
moval of this obstruction. The means to be employed, are, the 
warm stimulating foot baths, stimailating enemas, the vapour 
bath, emetics, and the free use of the compound lobelia pills. 

When the patient is in a sunken and depressed condition, a 
course of medicine will awaken an action in the system, and in 
recent cases, it will be certainly beneficial. 

Insanityf w^hich sometimes follows child-birth, is generally 
curable by medical treatment. The most impoi'tant of which are 
stimulating enemas, containing a portion of Lobelia; Emetics; 
the continued use of broken doses of lobelia in composition, or 
pepper tea, warmth applied to the feet, and the vapour bath and 
shower bath used when practicable. 

In many of the cases of insanity the patients w ill have a mor- 
bidly craving appetite, so that they will eat four times as much 
as is necessary, or the stomach can receive without impunity. 
In such cases, therefore, it is necessary to allow the patient as 
much food only as will be requisite for his sustenance, and not 
allow him to overload and oppress the stomach. 



SECTION II. 



DELIRIUM TREMENS— MANIA A POTU. 



(CRAZINESS FROM DRINKING.) 

This is a species of mental derangement occasioned by 
habitual drunkenness; or, by the intemperate use of opium. 

Symptoms. — The disease comes on after the excessive drinking 
of ardent spirits. The digestive powers are prostrated by the poi- 
sonous effect of the liquor; there is distress at the pit of the sto- 
mach, loss of appetite, nausea, great agitation and distress of 
mind, and tremulous motions of the limbs. 

As tlie disease continues the countenance of the patient becomes 
more expressive of alarm and suspicion; there is continual rest- 
lessness, and increased mental agitation. The tremour of the 
hands increase, and in some instances, the whole muscular sys- 
tem is agitated as though the patient were labouring under a fit 
of ague. " The eyes are cast about with quick and scrutinizing 
glances, or often fixed, apparently, upon some object that at- 
tracts the attention for a moment, and then quickly withdrawn. 
The patient is unable to sleep, either by day or night. He fan- 
cies that he sees snakes, cats, mice, and other animals in his 
room, and disgusting vermin crawling over the bed and on his 
clothes, or fancies that various persons have entered his room, for 
the purpose of robbing, killing, or injuring him. To avoid these 
and other horrid illusions, he often calls out loudly for assist- 
ance; runs to the door to make his escape, or to the window to 
leap out; is greatly agitated, vociferates, threatens, and some- 
times raves violently. Sometimes he fancies that he hears loud 
and strange noises around him over head, in an adjoining apart- 
ment, or loud and frequent knocking at the door. His mind 
and body are in a continued state of action^ he calculates, pro- 
jects, walks hurriedly about the room, thinks he picks up money, 
runs up to the window, and calls out to some imaginary person in 
the street, starts with terror and agitation from the presence of 
friglitful and disgusting apparitions, insists that he is well and 
confined with some sinister intentions against him, and re- 
<|uests to be soiTered to go out in pursuit of his usual occupation. 



296 DELIRIUM TREMENS. 

If the patient be flatly contradicted, he usually becomes much ex- 
asperated, and insists with vehemence on tiie correctness of his 
notions ; but when he is soothingly dealt with, he will now and 
then answer questions mildly and even distinctly; and by judi- 
cious management, may, in general, be restrained without any 
violent coercive measures." The skin is cool and generally 
covered with perspiration. 

In some instances the symptoms are slight, and pass off in the 
course of two or three days : whilst in others the patient becomes 
furiously crazy, does not recognize any one, halloos, or talks 
continually, and is controlled with difficulty. 

The Buration of Mania a Potu varies from two days, to se- 
veral-weeks, and in some instances it has been observed to con- 
tinue several months. Under a proper course of treatment, the 
patient will in general be restored to reason in less than a week 
from the commencement of the delirium. Much depends, how- 
ever, upon administering tlie remedies early in the disease, as in 
many instances when the disease is fully seated, it is with the 
greatest difficulty that the patient can be persuaded to take suf- 
ficient medicine to produce much effect. Mild cases of the dis- 
ease have frequently been observed to terminate speedily after 
spontaneous vomiting, or the supervention of diarrhoea. 

Fatalihj. — Delirium tremens rarely terminates fatally, except 
when it occurs in patients affected with extensive disease of the 
liver, or other important organ, or the constitutional energies are 
broken down, eitlier by disease, or by a long course of intempe- 
rance. 

Unfavourable Symptoms^ — A rapid and very small pulse; cold- 
ness of the limbs, the skin covered with cold sweat, constant de- 
lirium; the pupil of the eyes contracted, and twitching or work- 
ing of the muscles of the face, are symptoms indicating danger. 

Favourable Symptoms. — One of the most favourable symptoms 
in mania ^ potu is an ability to sleep tranquilly, even though it 
may be of but short duration. The practice of giving opium to 
produce sleep is often attended with injurious consequences, 
it prostrates the power of the stomach, and in many instances it 
increases the wakefulness and aggravates all the symptoms. At 
most it does but blunt the sensibility, without removing the 
cause, or restoring to the system its lost vitality. 

Mania i potu essentially consists in a weakened condition of 
the vital principle. The functions of the stomach are prostrated 
— digestion is suspended ; the system is not supplied with 
nourishment; the temperature of the body is reduced ; the bowels 



MANIA. 297 

are torpid or they may be provoked by the acid state of their 
contents, occasioning diarrhosa ; the nervous power is enfeebled ; 
and the brain is deprived of its natural healthy stimulous, the 
morbid effects of the liquor having also previously weakened its 
functions. Nature struggling to regain her lost power occasions 
the excited condition of the system attending mania d potu. 

Treatment — The treatment indicated for the cure of mania i 
potu is to be such as will aid the efforts of nature to throw off the 
disease. This is all that medicine can do to benefit the patient in 
any case of disease. The warm foot bath, vapour baths, emetics, 
pure stimulants, astringent or anti-canker medicine, and injec- 
tions are the means chiefly to be relied upon for the cure of this 
disease. 

The warm foot bath should be used before giving an emetic, 
and in mild cases it may supply the place of the vapour bath. 

The Vapour Bath relieves the symptoms by equalizing the cir- 
culation of the blood and nervous influence, restores for a 
time the natural heat of the system, and thus increases the sen- 
sibility of the stomach to the impression of medicines, rendering 
their operation more effective — throws deleterious substances out 
of the blood by exciting free perspiration and a determination to 
the surface : in fine it aids the effects of nature generally, to 
bring about a crisis, and cast off the disease. After steaming and 
the patient is nibbed dry, the surface may be bathed with No. 6, 
or stimulating liniment. 

Emetics, — I have invariably observed more benefit derived 
from the use of emetics than from any other means. Sometimes 
mania i potu is observed to terminate by spontaneous vomiting. 
Merely evacuating the stomach is not sufllcient, however, ex- 
cept in cases of a very mild character; the mucous membrane is 
in most instances thickly coated with morbid secretions, which 
3'equire the continued use of stimulating and anti-canker medi- 
cine for two or three days, besides frequent vomiting, before the 
stomach will become cleansed of morbid secretions, and its power 
of digestion restored. The third preparation of lobelia is the 
best form, yet it may be taken either in powder, infusion, or in 
tincture. Whatever form of lobelia is used, it should be given 
in sumac or bayberry tea. After the operation of an emetic, if 
the symptoms be not very much relieved, a teacup half full of 
a strong decoction of bayberry or sumac, adding from a tea- 
spoonful to a tablespoonful of the liquid of the third preparation 
of lobelia, must be given every hour or two, as the patient can 
be persuaded to take it, — this supplies the place of all other me- 
dicines. Sometimes it requires considerable management to in- 

2 N 



29'8 MANIA. 

(luce the patient to take medicine. Thus if a patient have a 
craving for liquor, he will often take a dose of medicine on the 
promise of having after it some gin or brandy, or whatever other 
liquor he may crave ; after taking the medicine a teaspoonful or 
more of the liquor should be given, diluted with water. I have 
known instances where lobelia has been taken freely in brandy 
and water, the patient obstinately refusing to take it in any other 
way. Some writers advocate the use of alcoholic liquors, as a 
remedy in this disease, wiiilst others oppose its employment on 
all occasions. I have in a few instances given patients liquor, 
but have never as yet observed any good effects resulting from 
it, but on the contrary, the symptoms have been almost invari- 
ably aggravated by it, except when given in very small quanti- 
ties. The disease requires stimulants, but they should be pure 
stimulants, and not the same poisonous articles that occasioned 
the disease. Although mania i potu seldom occurs whilst the 
patient continues to drink, the symptoms first appearing after the 
drinking is stopped, yet it is the drink that prostrates the vital 
powers and occasions the derangement which essentially consti- 
tutes the disease ; and the longer the drinking be continued the 
worse it will be for the patient. The long continued use of 
opium will cause mania a potu, and the practice of prescribing this 
article as a remedy in disease, is almost if not equally as absurd 
as to give a patient brandy to cure a disease brought on by its use. 
It is very desirable that the patient be able to sleep, not however 
by means of a drug that will deaden the sensibility of the brain^ 
prostrate the powers of the stomach, and probably produce se° 
rious congestion in the blood vessels of the brain, and prolong 
the disease. In a mild case of the disease a dose of opium may 
sometimes cause the patient to sleep, and not be materially in- 
jured by it; but in those cases, a vapour bath and emetic, 
followed by broken doses of lobelia, would bring the disease to a 
crisis much sooner, and the cure be more complete than by the 
use of opium, or probably by any other means. 

During the act of vomiting the patient's head should not be al- 
lowed to be lower than the level of his body, for the action of 
the blood vessels of the brain being weakened, the blood circulates 
sluggishly through them. Tliis requires that the head be kept 
somewhat elevated, in order to favour the returning circulation. 
When the skin and extremities are cold an injection should be 
administered and also a vapour bath, before giving an emetic. 
If these cannot be accomplished in consequence of the strenuous 
opposition of the patient, still the lobelia should be given in some 
form. If injections can be given the lobelia powder may be ad- 
ministered in this way in luke-warm water, which if retained 
will occasion vomiting, and exert even a more beneficial influ- 
ence upon the system than when taken into the stomach. 



MANIA. 299 

/?i/ectio7is.— Besides the plan just spoken of for placing the sys- 
tem under the influence of lobeli<a, stimulating injections will 
prove of especial service to the patient. By relieving the bowels 
they withdraw the excitement from the head. 

Tonics. — When tlie disease is overcome, bitter tonics may be 
used to restore digestion. 

Of the efficacij of Thomsonian treatment in reforming drunkards. 

Case I. — A man employed in the sheriff's office in this city, 
had indulged in the use of strong drink, until he became so much 
a slave to it that he was rarely entirely sober. He was sensible 
that he w^as on the high road to ruin, and occasionally he would 
form a resolution to quit the degrading practice ; but the func- 
tions of his stomach had become so much impaired that his^system 
was not furnished with sufficient stimulus, from food, to support 
the energies of his mind, and in moments of extreme mental de- 
pression, he would again resort to his accustomed drink, and as 
soon as one glass was taken his resolution was overcome, and he 
relapsed back into his former habits. Speaking to a friend one 
day of his anxiety to quit drink, and of his unsuccessful attempts 
to do so, from the occasional hankering for stimulus, his friend 
advised him to get some of the Thomsonian composition powder, 
and when he felt the want of a stimulus to take a dose of the com- 
position. He accordingly obtained the composition and on 
taking it as directed, it furnished an agreeable stimulus, 
without disordering the brain; overcame the desire for liquor, 
and at the same time restored the tone of his stomach to a healthy 
condition ; so that in the coui^e of a year he became changed 
from drunkenness and wretchedness, and enjoyed perfect health 
and a fine glow of spirits. He is now actively engaged in the 
temperance cause and through his example and persuasion others 
have been induced to resort to the use of the composition powder, 
with the same happy result. 

Case II. — A merchant of this city who had formerly resided 
in the south, had contracted the habit of excessive drinking, and 
Avas occasionally attacked with mania i potu. Having experi- 
enced good effects from vomiting he determined on taking a 
course of Thomsonian medicine, to have his stomach thoroughly 
cleansed and then to refrain from the use of strong drink altogeth- 
er. He stated to me that he had often resolved to quit the degra- 
ding practice, but that his spirits sometimes became so much de- 
pressed and his appetite so bad, tliat his resolution to refrain from 
liquor gave way, and he would again take a glass; — this was soon 
succeeded by another, and thus he would go on drinking until 



300 >iANIA. 

his stomach turned against it, when he would he attacked with 
symptoms of mania i potu. After this patient had placed him- 
self under Thomsonian treatment he did not relapse again into 
Jiis former habits except on two or three occasions, and then a 
course of medicine was administered, and the general course of 
treatment adopted that is recommended for mania a potu, which 
shortened the duration of the disease, and by the daily use of pure 
stimulants the digestive powers were finally restored so that the 
patient was exempt from that state of mental depression, which 
had so frequently led him to resort to spirituous liquors. This 
gentleman has continued a sober man during the past two years, 
and doubtless will continue so. 

Case III. — During the summer of 1838, a man called at my 
office, and gave me the following history of his case. When 
about the age of thirty he became dyspeptic from close attention 
to business, and experienced at times extreme lowness of spirits, 
with trembling of his hands. An acquaintance recommended 
hrandy and w ater, which he took and experienced temporary re- 
lief; continuing to tal^e his glass of brandy and water, when- 
ever he felt the want of a stimulus, lie at length found that the 
dyspepsia was gaining ground, and that the attacks of nervous 
weakness were more frequent, requii ing a more frequent repeti- 
tion of the brandy; and finally his nervous energy became so 
prostrate that he was induced to fly to his accustomed stimulus, 
the first thing in the morning, and to continue under its influence 
during the whole of the day. It was now sixteen years since he 
commenced theuse of brandy, and (said he) ** to speak plainly, I 
am a confirmed drunkard." He w^as walling to submit to any 
course of treatment, that would restore his digestion, so that he 
could do without the brandy, which he was sensible had gained the 
upper hand of him. I told him if he was anxious to quit the use of 
hrandy, I had no doubt that he could do it and be restored to 
health. He placed himself under treatment, which consisted in an 
occasional course of medicine and the free use of cayenne pepper 
more especially at meals, and when he felt the want of his accus- 
tomed stimulus to take a dose of No. 6 or of composition. The 
result was most happy — he quit the use of bi'andy without much 
difficulty ; his digestion was restored, and he now enjoys good 
health, not having taken any kind of intoxicating drink during 
a period of more than two years. 

The above are not the only cases of the kind that have occur- 
ed under my ow n immediate observation ; I could mention seve- 
ral others of equal interest and importance, where men addicted 
to drunkenness have become reformed partly through the aid of 
Thomsonian treatment, which affords a pure stimulus, entirely 
free from intoxicating properties, and at the same time has the 
eflcct to correct and strengthen the digestive functions. 



CHAPTER XIII. 



SECTION I. 



HE JIB ACHE. 



Pain in the head in most instances is occasioned by a disor- 
dered condition of the stomach. 

Slight attacks of headache may very often be removed by 
having the head rnbbed freely with the liands, which favours tlie 
returning circulation from the head. Bathing tiie furehead with 
some volatile stimulant, as No. 6, spirits of camphor, or harts- 
liorne, or with simple vinegar, or whiskey, will sometimes re- 
move it. When the feet are cold, they should be warmed by the 
foot bath, or by other means, and the patient take composition or 
pepper tea. Snuffing composition or No. 6 up the nose by stim- 
ulating to excitement the secretions of this organ, will sometimes 
cure simple headache. 

When the pain is violent and not relieved by the means already 
mentioned, an emetic or the repetition of three or four stimulating 
injections to relieve the bowels and attract the circulation from 
the head, will seldom fail of curing the pain. 



SECTION II. 



SICK HEADACHE. 



When there is pain in the head attended by sickness at the sto- 
mach with or without vomiting, it is termed sick lieadache. It 
always arises from a disordered condition of the stomach ; pa- 
tients almost always experiencing much relief from the pain in 
the head after free vomiting. 



302 SICK HEADACHE. 

In many instances sick headache occurs periodically ; in some 
the attacks come on every week, in others at intervals of two or 
three weeks. Persons predisposed to this form of disease are es- 
pecially liable to an attack, from some change of habit, for in- 
stance, missing a regular meal, riding in the cold, or sitting some 
hours in a crowded assembly. Inacuracies in diet, fatiguing 
exercise, exposure to cold, and getting the feet damp, frequently 
occasion an attack of sick headache. 

Treatment — The best remedy for sick headache is an emetic. 
This taken in the commencement of the attack will not only mode- 
rate the symptoms but very generally after the free operation of 
an emetic all the distressing symptoms will be speedily removed. 
If the feet be cold apply the warm foot bath or vapour bath and 
let the patient take a dose of composition or pepper tea before 
the emetic be given. 

Injections. — I have known sick headaclie speedily cured by the 
use of injections alone. Prepared in the usual form of com- 
position or pennyroyal tea, adding a teaspoonful of lobelia, 
the injections will relieve the pain in the head, and if applied too 
in the onset of the attack, will never fail of proving beneficial. 

In milder cases and when the stomach is not very materially 
disordered, it may be sufficient that the patient get to bed, drink 
some warm tea, and have warm applications to the feet. 

Sleep, — When a patient can obtain a few hours sleep, the head- 
ache is generally cured for the time, whether they have or have 
not taken medicine previously. The practice liowever of taking 
an emetic in the commencement of sick headache, and repeating 
it every time that there are symptoms of an approaching attack, 
will not only prove the most effectual means for relieving the 
symptoms, but if the practice be persevered in, and medicine be 
taken to strengthen digestion the liability to the attack will be 
greatly lessened, and in most cases the patient will be freed alto- 
gether from the attacks. 

Bitter tonics should be taken once or twice a day, more especi- 
ally after dinner. Wormwood, centuary, balmony, golden seal? 
quassia or almost any combination of bitters may be employed. 
It is the tonic principle that is needed, and it is not important 
that any one particular article should be employed. 

Mkaline Bitters.— T?ikc a handful of wormwood and a table- 
spoonful of hickory ashes, pour on a pint of boiling water; a wine 
glass full to be taken after meals, cold. This preparation is ap- 
plicable in cases of heartburn or sour eructations. 



SICK HEADACHE. 505 

Salt and Vinegar. — A disordered condition of the stomach will 
in some instances be rectified and digestion restored hy the use 
of salt and vinegar. In these cases patients have an inclination 
for acids. 

Costiveness almost universally attends sick headache. The 
majority of patients take some kind of purgative medicine to re- 
move costiveness, which leaves the bowels in a w orse and weak- 
er condition than they were before ; the costiveness continues and 
more physic is taken, and in this way many persons continue 
this practice for a succession of years until finally the digestive 
powers become so much weakened, and the functions of the bowels 
prostrated to such a degree that without a most careful attention 
to diet, a natural passage from the bowels is seldom procured. 
It is indeed doubtful which has done the most injury to the human 
constitution the use of purgative medicine or of strong drink. — 
Costiveness is occasioned by a weakened condition of the func- 
tions of the bowels, and to assist and strengthen the peristaltic ac- 
tion of the bowels, and excite the secretions of their mucous mem- 
brane are the essential indications for the cure of habitual cos- 
tiveness. In many instances this may be effected by the daily 
use of bread made of unbolted wheat flour, or by taking every 
evening for supper a gruel, or mush made of the same material, 
and avoiding the use of cathartics. The bran is supposed to act 
as a mechanical stimulus. Where costiveness is attended by 
heartburn or sour eructations, finely pulverized charcoal will be 
found especially beneficial ; purified charcoal should be used 
when it can be obtained. The dose is a large teaspoonful taken 
in composition or spiced bitter tea, or it may be taken in boiled 
miikc It should be taken an hour or two before meals. 

Capsicum taken freely at meals or immediately after, will 
stimulate the action of the bowels, and, in many cases of con- 
stipation, will be sufficient to overcome it. 

Injections. — Where the use of purgative medicine has been 
continued for a succession of years, it may be necessary, besides 
the means above mentioned, to assist the bowels occasionally by 
the use of the syringe. There is probably not a case of obstinate 
constipation of the bowels, in which the mucous membrane of 
the bowels is not coated with thickened secretions — forming a 
complete false membrane, which occasionally passes off in long 
pieces, somewliat resembling an intestine. The removal of this 
false coating from the mucous membrane of the bowels is essential 
to the restoration of their natural functions. Purgative medi- 
cines operate upon the bowels as a foreign substance,~something 
not congenial ; and provoke an action — an effort to cast off the 



304 SICK HEADACHE. 

offending substance, causing the mucous surfaces to throw out a 
coating of thickened secretions to shield them from the deleterious 
impression of the cathartic; therefore cathartics instead of clean- 
sing the bowels of "canker" as Dr. Thomson expresses it, give 
the canlier a deeper liold, and thus add to the difficulty. That 
which is required for cleansing the lining membrane of thickened 
morbid secretions or canker, is to excite the bowels by pure stim- 
ulants, capsicum, composition, and compound lobelia pills ; and. 
the use of stimulating and astringent injections. 

Patients subject to attacks of sick headache should use the pre- 
caution, to dress A^ery warmly whenever they ride out in cold or 
damp weather. With regard to headache being occasioned by 
getting the feet damp, too few persons in the community are fully 
sensible of the influence which dampness applied to the feet, 
excites over the digestive functions, and of the extent of derange- 
ment which it frequently occasions. 

Another Variety of Headache, — Severe pain in the forehead 
and eye balls, is sometimes occasioned by disease of the frontal 
sinuses which are small cavities in the bones of the skull, 
immediately above the eye brows. These small cavities are 
lined with a mucous membrane which is continuous with the mu- 
cous membrane of the nose. The disease is occasioned by taking 
cold; and prevails during the cold and damp weather of spring 
and autumn. The disease is in no wise dangerous, but some- 
times continues several days, and occasionally for weeks before 
the pain is removed. In the first place the mucous membrane is 
weakened by the influence of cold, inflammation ensues which 
terminates in the free secretion of a thick, yellow or greenish 
matter, which is discharged by the nostrils and then the pain 
usually subsides. 

Treatment. — Besides constitutional treatment such as, taking 
freely of warm stimulating teas, to favour perspiration, benefit 
will be derived from breathing through the nose, the vapour of 
vinegar and water, and using the composition powder, or cayenne 
pepper as a snuff, which will excite the secretions, and in this 
way afford relief. 

Not unfrequently is this form of headache accompanied with a 
deranged condition of the system generally, the affection in the 
head being a mere branch of disease, the root of which is in the 
stomach and bowels. Hence in violent cases of headache accom- 
panied with symptoms indicating a disordered condition of the 
stomach and bowels, — a furred tongue, loss of appetite, bad taste 
in the mouth, costive bowels, and chilliness, and flashes of heat 
— the system must be warmed by the use of stimulants internal- 
ly ; and external warmth applied either by warm bricks placed 



TOOTHACHE. 305 

around the patient or a vapour bath, administered, followed by 
an emetic to cleanse the stomach, and if the bowels require assist- 
ance let it be done by enemas. After this the patient may take 
occasionally of some stimulant — composition, spice bitters, gin- 
ger, or simple herb teas, and avoid exposure to the cold or damp- 
ness. 

I have never known a case of headache that was not either 
cured or greatly relieved by a vapour bath and emetic. 



SECTION III. 



TOOTHACHE. 



The curableness of toothache by local applications depends 
greatly upon the condition of the tooth and the cause of the pain. 
Thus if the tooth be hollowed, and the pain arise from the pre- 
sence of acrid matter in the decayed part, or from exposure of the 
nerve to cold, the pain may be greatly relieved by tilling the hol- 
low of the tooth with cotton wet with thd third preparation of lo- 
belia, oil of cloves, spirits of hartshorn, No. 6, or spirits of cam- 
phor ; together with warm applications to the check, such as 
bags of hot ashes, salt or sand, or a towel folded up and applied 
as hot as can be borne. When a dry heat does not answer tiie 
purpose, a small bag of hops or of bitter herbs dampened with 
vinegar, or cloths wrung out of hot water may be ap])lied. 

Toothache may be cured in many instances, by placing the 
feet in warm water, and taking freely of composition or pepper 
tea. In violent cases an emetic should be given, followed by 
broken doses of lobelia; stimulating teas and warm applications 
to the feet. A very intelligent and experienced Thomsonian once 
told me that he generally prescribed a dose of the third prepar- 
ation oHobelia for toothache, and said that it seldom failed of re- 
moving the pain. 

It very often happens that an abscess forms at the extremity 
of the root of a tooth which finally swells out the gum, forming 
what is commonly called a gum bile. External applications are 
seldom of permanent benefit in such cases, the only certain cihre 
is the extraction of the tooth. After the abscess discharges, the 
pain generally vanishes. When a tooth has become diseased at 
its root, it will most probably be a frequent source of annoyance 
as long as it remains in the jaw, as plugging will seldom answer 
any good purpose in such cases. 

-2 



306 TOOTHACHE. 

Whenever teeth begin to decay externally they should be plug- 
ged by a dentist well acquainted with the business. Persons re- 
siding ill the country are too apt to neglect their teeth when they 
begin to decay, and do not apply to a dentist until they experi- 
ence the disadvantage of the loss of some of their teeth and the 
partial decay of others. A skilful dentist can generally prevent 
the further decay of a tooth if timely applied to. Altliough the 
teeth may be preserved by plugging them, yet they are often 
ruined by too much filing. Dentistry like the Thomsonian sys- 
tem, has been greatly abused by quacks, who have engaged in it 
without being acquainted with its principles. A dentist properly 
acquainted with his profession will be very cautious how he uses 
the file, knowing as he does the importance of preserving the 
enamel of teeth, and of the liability of a rapid decay of them 
when a portion of the enamel is destroyed. I have known indi- 
viduals condemn dentistry altogether; because they have observed 
their teeth to decay more rapidly after having had them filed. It 
is quackery in dentistry that should be condemned, and not the 
principles of the science. There is scarcely a branch of science 
the principles of which can be more plainly demonstrated, than 
that of dentistry. 

Having made allusion to Thomsonian quacks I will explain 
myself ; not meaning to be understood as applying this term to 
every one who engages in the practice without having had a 
regular medical education, — indeed some of the most successful 
practitioners that I have ever yet known, have been men without 
a regular medical education — who have established a correct 
method of reasoning upon things in general, and possessing good 
common sense, were able to comprehend the true principles of 
Thomsonism by reading the works of its founder, and possess- 
ed sufficient moral courage to pursue the treatment thoroughly 
and perseveringly, as their mature judgment dictated, uninflu- 
enced by the slander of gossips, the opposition of the prejudiced, 
or the timidity of professed friends. I would apply the term 
quack to one (whether he have been educated in a college or on a 
farm) who announcing himself a Thomsonian doctor, and railing 
against all mineral poisons, employs mandrake and other 
vegetable poisons, and deleterious compounds, as improvements 
on the Thomsonian system ; and who instead of being governed 
in his practice by the general principles of the Thomsonian sys- 
tem, employs inefficient syrups, and worse than useless cathartics 
in the place of Thomsonian medicine. Such practitioners may 
very properly be termed quacks in medicine. 



DISEASE OF THE EAR, 



SECTION IV. 



EARACHE. 

This distressing complaint is of frequent occurrence. It pre- 
vails most in early life. 

Causes. — Pain in the ear is generally a consequence of expo- 
sure to cold and dampness. Those who are predisposed to this 
form of disease, are extremely liahle to an attack by getting 
their feet damp. Children are peculiarly liable to a discharge 
of matter from the ear, and they generally suffer more or less 
pain for several days before the ear begins to discharge, attended 
with a flushed countenance and some degree of fever. 

Treatment— When earache is caused by cold, it may be re- 
lieved by steaming the side of the head and using the warm foot 
bath. Steam may be applied to the ear through a funnel placed 
over a vessel containing boiling water. If there should not be 
sujficient steam, a small hot stone should be put in the water. — 
After the steaming, a portion of cotton wet with the tincture of 
lobelia, should be kept in tiie ear, or dry cotton may be employ- 
ed if the tincture cannot be readily obtained. The heart of a 
roasted onion put in the ear will sometimes relieve earache; it 
should be hot, or as warm as can be borne. If tliere should be 
an abscess forming, the same course of treatment may be pur- 
sued; or apply a warm poultice to the ear, with a view to hasten 
a discharge of the matter. Syringing the ear with warm soap 
suds will sometimes relieve the pain. 

If the system be much disordered, an emetic will be beneficial, 
after which broken doses of lobelia may be given in order to 
cause a moderate degree of relaxation of the system, and to 
equalize the nervous influence. 

Case. — A little girl of scrofulous constitution, who had been 
subject to a running from her ear, was attacked with violent 
pain in the ear and side of the head, attended with an extremely 
offensive discharge from this organ. A variety of local rcmedie i 



308 RUNNING OF THE EAES. 

were employed witliout any apparent benefit After having suf- 
fered continued pain for two days and nights, a full course of 
medicine was administered, which afforded complete relief. Af- 
ter the course small doses of the tincture of lobelia were given 
every two or three hours, and about the fourth of a teaspoonful 
of green lobelia was administered by enema, whenever there 
was a return of the pain, which gave immediate relief, and ena- 
bled the patient to sleep. 



SECTION V. 



RUNNING OF THE EARS. 

A discharge of matter from the ears is by no means uncom- 
mon in children. Those of a scrofulous constitution are more 
liable to it, still it is often observed in children who are not pre- 
disposed to scrofula. 

This disease occasionally injures the hearing, though more 
commonly it is not attended by any permanent injury to the 
hearing, even though the discharge continue at intervals during 
a period of several years. 

The running in many instances is from the parts immediately 
belov/ the cavity of the ear. In the first place a small abscess 
is formed near the cavity of the ear, and breaks into it and is 
thus discharged. In other instances the disease is confined to the 
membrane lining the cavity and drum of the ear. 

Treatment — When a child of a weak and delicate constitu- 
tion is affected with running from the &ar, a permanent cure is 
rarely accomplished until the general health be improved. It is 
therefore of more importance in such cases to use means for im- 
proving the constitutional health, than to depend upon any ap- 
plications to the ear. 

Thei'e are no means so effectual for improving the health as 
an occasional emetic, or a full course of medicine. If the tongue 
be coated, a strong tea of bayberry must be given once or twice 
a day, or in place of this use the No. 3 pills. 

Tipsissaxva — A strong tea or syrup of pipsissawa, may be 
used with benefit in this and other forms of disease in children, 
more especially in scrofulous eruptions. 



KUNXING or THE EARS, 509 

Yellotv dock, sarsaparillaf and gidac shavings, combined in 
equal portions, simmered an hour, and then strained, sufficient 
sugar added to form a syrup, and then simmered again, forms 
a useful syrup in all cases of running sores in children, more 
particularly in cases ^Yherethe disease has been of long continu- 
ance. The dose of the syrup is from a tablespoonful to a wine- 
glassful, according to the age of the patient. 

Tonics. — When the discharge is profuse and the patient debili- 
tated, the spice bitters, or some other form of tonic must be em- 
ployed, unless the syrup above mentioned be given. 

Local Applications, — Syringing the ear with castile soap and 
water, or with a strong tea of bayberry, will be beneficial. A 
strong tea made by steeping in boiling water a compound of bay- 
berry, aspen poplar bark and gum myrrh, will not only serve to 
cleanse the parts, but will strengthen the healing efforts of 
nature. Many persons doubt the propriety of syringing the ear 
with stimulating teas, supposing that they may be carried into 
the head. The drum of the ear which is not more than an inch 
and a half from the external opening of the ear, forms a barrier 
to the passage of substances beyond it; neither is there any dan- 
ger from dropping stimulants, such as No. 6, into the ear. 

When the discharge has been long continued, No. 6 alone, or 
combined with about an equal quantity of bayberry or poplar 
bark tea, should be dropped into the ear two or three times a 
day, or if this be very painful, a simple tea of myrrh may be 
used, either of its usual strength or diluted with water or bay- 
berry tea. 

In some instances the matter discharged is so acrid that it 
excoriates the ear, causing the surface of it and the parts 
below the ear to be continually sore and inflamed; the glands 
back of the ears and on the side of the neck are apt to be more 
or less swollen; and sometimes an eruption appears over a part 
of the head and face, which very often continues for weeks, and 
sometimes it requires several months for the eruption to be en- 
tirely cured. Where the external ear becomes excoriated, or 
sores break out on the skin; the parts must be kept from the air 
by the application of tar ointment, or some kind of adhesive 
salve, in order to protect the raw surface from the atmosphere. 
Apart from constitutional treatment there is nothing of more 
importance in the cure of eruptions, of the character above men- 
tioned, than to protect the parts from the action of the air. It 
does not make much difference what kind of salve or ointment 
is used, provided it will effectually exclude the air. In most 
instances the parts suppurate and discharge freely soon after 
applying a salve or ointment, but by continuing the application, 



310 DEAFNESS. 

SO as to keep off the air, the parts will soon heal, unless the sys- 
tem be much diseased, and the healing power of the constitution 
thereby enfeebled. When the parts suppurate freely, the oint- 
ment or salve will of course require to be removed daily, in or- 
der to cleanse the parts, but the exposure should not be continued 
longer than is necessary to dress the sores. Such eruptions 
should never be dried up by the application of lead water, or 
driven into the system by the use of salts, or other such cooling 
medicines. For although they might not be followed by immedi- 
ately bad effects, yet serious consequences have often resulted 
by applying lead water, or a solution of corrosive sublimate to 
eruptions on the face and head; and by drawing the determining 
powers from the surface by purging. Hence some physicians 
advise parents to use no means to cure eruptions about their chil- 
drens heads, considering the eruption as a safe-guard against 
internal disease that might prove of far more serious conse- 
quence. I have never known any bad effects to arise from cur- 
ing eruptions about the head upon the Thomsonian plan. The 
internal remedies used for curing the disease, will also prevent 
it from seating itself in the system. 



SECTIOSr VI. 



DEAFNESS. 



Deafness may depend upon palsy or other diseased condi- 
tion of the nerve of hearing; from thickening of the drum of the 
ear, or it may proceed from disease of other parts of the internal 
apparatus of the ear. Hardness of hearing sometimes depends 
upon a collection of hardened wax in the drum of the ear. 

Complete deafness is very rarely cured. When hardness of 
hearing is occasioned by indurated wax in the ear, it is very 
readily remedied by syringing the ear with warm soap suds, 
made of castile, or palm soap. A convenient way to syringe 
the ear, is to have the warm suds in a basin with one edge 
of it placed against the neck immediately below the ear, and 
inject the liquid into the ear, with sufficient force to reach the 
farther extremity of the cavity. The syringing to be continued 
until the wax softens and is washed out. 



CHAPTER Xiy. 



SECTION I. 



F^LFITATIOJ^ OF THE HEART, 

An irregular beating, and fluttering motion of the hearty 
very frequently attends dyspepsia, sick headache, neuralgia, 
asthma, consumption, hysteria, gout, constitutional debility, and 
in persons of nervous temperament, it is frequently occasioned 
by any slight derangement in the system. The use of strong 
coffee, tobacco, an oppressed condition of the stomach from food 
that is hard of digestion, grief, anxiety or any sudden emotion 
of the mind will in some, occasion irregular throbbing and flut- 
tering motions of the heart. 

Of all the cases of irregular palpitations of the heart, there is 
probably in nine of every ten of them, no disease of the heart ; 
the irregularity of the motions of the heart being caused by a 
weakness and derangement in the nervous system. A disordered 
state of the stomach weakens the nervous power, and the weak- 
ened condition of the nervous influence, may occasion disorder 
of the functions of the heart, constituting what is termed a func- 
tional disease of the heart. Thus sick headache and palpitation 
of the heart are often associated ; both arising from the same 
cause. 

Treatment — Palpitation of the heart being in most instances 
merely a symptom of disease, the original seat or cause of which 
is generally a disordered condition of the stomach, it does not 
demand any especial treatment, apart from that wliich is re- 
quired for correcting the disordered condition of the stomach, 
and restoring digestion. Thus a patient may have an attack of 
hysteria, accompanied with violent pain in the head, and palpi- 
tation of the heart — these being mere symptoms arising from con- 
stitutional disease, the seat of which is commonly in the stomach, 
the same course of treatment will be sufficient to remove all 
these diff'erent symptoms. If ten thousand persons w'ere to become 
diseased from one general cause, there would probably not be 



31£ PALPITATION or THE HEART. 

two cases in which all the symptoms of disease would be pre- 
cisely alike. Whilst in one there might be sick headache with 
palpitation of the heart, another might have palpitation of the 
heart without sick headache, and another sick headache without 
the irregular throbbings of the heart. Asthma in one would be 
accompanied with fluttering of the heart, in another it would be 
accompanied with headache alone, whilst the majority would 
probably be exempt from any functional derangement of this 
organ. Disease of every variety is produced by a weakened con- 
dition of the principle of life, and notwithstanding the great di- 
versity in the symptoms which are presented in the various 
forms of disease the general indications of treatment are few, and 
the necessary remedies also are few and simple. 

If palpitation of the heart be accompanied with manifest symp- 
toms of a foul stomach, an emetic will be the best remedy ; which 
should be preceded by the vapour, or the w^arm foot bath. 

When irregular palpitation of the heart becomes of so frequent 
occurrence as to need especial attention, the indications of cure, 
are, to restore the natural balance of the circulation of the blood, 
to cleanse the stomach and bowels of " canker" and strengthen 
digestion. This will prevent the heart from becoming perma- 
nently diseased in its structure ; a circumstance which sometimes 
occurs in consequence of long continued palpitation of the heart 
depending upon constitutional disorder, and general debility. 

Persons of full habit of body, w^hose digestive powers are en- 
feebled by a long continued course of excesses in eating and 
drinking, and the inordinate use of tobacco, are very liable in 
advanced life to frequent attacks of strong, irregular throbbing, 
and tremulous motions of the Ijeart. I knew an instance where 
a gentleman was confined to the house several months labouring 
under symptoms of disease of the heart, yet by the free use of 
Thomsonian remedies, consisting chiefly of capsicum, a com- 
pound of the astringent or anti-canker medicines and bitters, he 
recovered perfectly from all symptoms of this disease. 

Palpitation of the heart sometimes depends upon a weakness 
and soreness in some portion of the spine, the stomach not being 
materially disordered. Here it will be proper to employ the 
vapour and shower bath, stimulating applications to the spine, 
together with such constitutional treatment as the condition of 
the general health may demand. 



SECTION II. 



ORGANIC, OR STRUCTURAL DISEASE OF THE 
HEART. 



The preceding section treats of functional derangement of 
the heart, unattended with a change in the structure of the lieart 
itself. Under the present head I shall make some brief obser- 
vations in relation to structural disease of the heart, and point 
out the appropriate treatment. 

The heart, like other organs of the body, is liable to changes 
of structure, such as an enlargement of its dimensions, with unu- 
sual thinness of its walls, enlargement of the ventricles of the 
heart, disease of the valves, the formation of cartilage within 
its cavity, &c., all of which depend originally upon a disordered 
condition of the system, or upon an originally feeble organiza- 
tion. Violent mental emotions have been observed to cause dis- 
ease of the heart. Instances have occurred in which sudden ter- 
ror, anger, or excessive joy, has determined the blood so vehe- 
mently to the heart as to cause immediate rupture of its ventri- 
cles." 

Of the Symptoms. — Many of the symptoms which attend dis- 
ease of the heart, also accompany other forms of disease, so that 
even experienced physicians sometimes find it difficult to distin- 
guish disease of the heart from mere sympathetic derangement. 

Asthma is very frequently attended by palpitation of the heart; 
and again, structural disease of the heart is accompanied by dif- 
ficult respiration resembling asthma. Patients affected with 
disease of the heart experience great oppression and difficulty 
of breathing on using exercise; the same symptoms attend on 
asthma and dropsy of the chest; and even when patients are 
extremehj feeble, and without being affected either with asthma, 
dropsy, or disease of the heart, they are liable to experience great 
oppression in the chest, difficulty of breathing, and violent pal- 
pitation of the heart from over exertion. The livid hue of the 
lips observed in cases of heart disease, alike accompanies parox- 
ysms of asthma. The inability to lie down, however, only con- 
tinues during a paroxysm of asthma; whereas in disease of the 
heart it is generally continued, or at least the patient can sel- 
dom lie on the right side, with the head on a level w^ith the 
body; the same, however, attends hydrothorax. The pulse 

2 P 



314 DISEASE OF THE HEART. 

which is irregular in structurl disease of the heart, is also inter- 
mitting in functional disease of the heart, and also in other vari- 
eties of disease. Alarming dreams and sudden startings dur- 
ing sleep, with a distressing sense of suffocation which are men- 
tioned among the symptoms attending disease of the heart, are 
by no means peculiar to that form of disease alone. 

^* When we find a patient complain of more or less habitual 
dyspnoea," (difficulty of breathing) *^ greatly aggravated by 
corporeal exertion; slight oedema, (dropsical swelling) of the 
feet: a puffy and anxious appearance of the countenance, with a 
livid hue of the lips; frequent palpitations or tremulous action 
of the heart during the paroxysms of dyspnoea; the occasional 
sudden occurrence of an elastic puffy swelling of the lower eye-lids 
and the upper lip; an irascihle temper; quick and short inspira- 
tions; a deep purple and bloated aspect of the face during the 
paroxysms of difficult breathing; with an absence of the pecu- 
liar wheezing and rattling noise in the lungs; and a free secre- 
tion of urine: when these symptoms are noticed, we have strong 
reasons for presuming that there exists some disease of the 
heart." — Eberle. 

Difficulty of Cure, — The majority of cases of confirmed struc- 
tural disease of the heart, are probably incurable; yet by espe- 
cial care on the part of patients to avoid excesses of eatings 
drinking, exercise, &c., together with the employment of means 
to support the natural warmth of the body, by which the deter- 
mining powers will be kept to the surface, and the blood caused 
to flow to the extremities, and thus be prevented from being con- 
fined to the internal vessels crowding upon and oppressing the 
heart, the symptoms may be much relieved, and in some in- 
stances cures have been effected even when the disease had as- 
sumed a very serious character. When death takes place from 
disease of the heart, it is generally very suddenly, and sometimes 
without any previous symptoms indicative of more than usual 
danger. 

Treatment — An important indication in the treatment of dis- 
ease of the heart, is to maintain an equal circulation of blood 
throughout the system. The means to be employed are the warm 
foot bath, the vapour bath, pure stimulants taken into the sto- 
mach, stimulating enemas, frictions of the surface, stimulating 
liniments, or embrocations applied to tlie extremities, and lastly, 
yet of still greater importance, the administration of an occasional 
course of medicine. The continued use of hroken doses of tinc- 
ture of lobelia, will prove beneficial. If the system be in a re- 
laxed condition, and the complexion pale, bitters must be also 
employed. 



DISEASE OF THE HEART- 315 

Case. — A yoiiiig man, by the name of Bullock, who was la- 
bouring under disease of the heart, of a severe character, the 
throbbings of the heart being constantly violent, and irregular, 
and his flesh much wasted. The physician who attended him was 
a man of considerable eminence in the profession, and declared 
the case to be an incurable disease of the heart. It was pro- 
posed to the physician that the patient be taken to the country. 
He replied thcit it would be altogether useless, as the disease was 
of that character which afforded no grounds for hope of recovery. 
Under these discouraging circumstances, the patient was taken 
to a Thomsonian infirmary, which was under the superintend- 
ance of Frederick Plunier, and there he had a course of medi- 
cine administered to iiini every few days. Under this treatment 
he improved so much that after the twentieth course of medicine 
was given, he was almost free from symptoms of disease of the 
heart. Tliis gentleman subsequently regained perfect health 
and engaged in the study of law, and now resides in one of the 
southern states. 

In another instance a gentleman of my acquaintance, past his 
fiftieth year, who had been a full liver, was confined to the house 
several months with well marked symptoms of disease of the 
heart. By a careful avoidance of all injurious influences, and 
the continued daily use of Thomsonian remedies, this patient be- 
came entirely free from symptoms of heart disease, his general 
health being fully restored. 

The above are the only cases of disease of the heart (admit- 
ting them to have been of that character) in wiiich to my know- 
ledge the effects of a persevering and well applied course of 
Thomsonian treatment in this disease has been fully tested — 
The tendency of Thomsonian treatment in equalizing the circu- 
lation, and improving the general health, and the rei^arkable 
influence of lobelia in equalizing nervous energy even when ad- 
ministered in small doses, affords sufiicient ground to warrant 
confidence in the practice even though the disease may hereto- 
fore have baffled the treatment pursued by the medical profes- 
sion. 



Excesses of ever ij kind to be avoided.— Versons labouring under 
disease of the heart, cannot observe too much caution in the 
avoiding of excesses, in eating, drinking, and in exercise. If 
the stomach be oppressed with too much food, or by the. food 
being hard of digestion, it will more or less disturb th.e equi- 
librium of tiie circulation of the blood and thus increase the dis- 
turbance in the regular action of the heart. Much the same ef- 
fects will be produced by exposing the feet to dampness which 
causes the blood to recede from the sarface and oppress the heart. 



516 DISEASE or THE HEART. 

Too niiicli exercise is apt to occasion great distress at the heart, 
with violent palpitations. 

Many persons may question the propriety of administering 
a course of medicine, to a patient labouring under disease of the 
heart Experience has proved however, that a patient atlected 
with disease of the heart who is unable to walk a square, 
without experiencing the greatest distress and difficulty oi 
breathing will go through a full course of medicine without 
affecting him in this way, to any considerable degree. During 
the winter of '38 I was requested to visit a patient a Mr. Kates, 
who was labouring under a most severe form of disease of the 
heart. The case was utterly hopeless of cure, his legs were 
dropsical requiring to be punctured every few days to drain ofi 
the iiuid ; there was an accumulatioii of water in the cavity ol 
the abdomen; he was extremely emaciated, and the action of the 
heart continually violent, labouring, and irregular, so that it 
was with diflicuity that he could walk a few^ steps without sup- 
port, and he was compelled to continue night and day in a sitting 
posture. I commenced treating the case with the view only oi 
affording relief, and after applying the steam bath daily, which 
he bore very well, and having taken composition tea, occa- 
sionally, three or four days, I administered a full course of medi- 
cine, and did not perceive any unusual excitement or increased 
dilSculty of breathing during the operation; not even immediate- 
ly after vomiting. This circumstance admits of a ready ex- 
plaiiation, namely: the means employed equalized the circulatio^i 
of the blood, and thus prevented it from crowding upon the heart. 
Thus a patient labouring under a paroxysm of asthma, who is 
unable to walk across a room, or scarcely is stand erect, will be 
materially, if not entirely relieved by a thorough emetic, and 
still more certainly by a full course of medicine. 

I attended a patient living in Woodbury, N. J., a man in ad- 
vanced life, labouring under a most severe fo);m of asthma at- 
tended with well marked symptoms of organic disease of the 
heart. It was with diiSculty this patient could v/alk ten feet, 
and he had not lain down daring a period of twelve months.— 
Every extra effort would cause violent throbbing and distress at 
the heart, still this patient would go through a course of medi- 
cine and feel much relieved during the operation. The course 
of treatment adopted in tliiscase, which consisted chiefly of the 
free use of the third preparation of lobelia, given in a strong de- 
coction of bayberry and suoiac berries, repeating the dose when- 
ever the symptoms of oppression were more distressing, together 
with the daily application of the vapour bath, warmth to the feet, 
the use of injections, and stimulating liniment to the surface, not 
only removed the asthma, but so far restored the natural action 
of the heart, that the patient in a few weeks after the commence- 



BIEEDIXG TROM THE lUNGS. SIT 

ment of the treatment, was able to walk a mile, without expe- 
riencing much inconvenience from the exercise. 

The same course of treatment that is adapted to the cure of 
asthma, is precisely that which is required in disease of the 
heart or dropsy of the chest, so that however difficult it may be 
to decide the precise character, form or location of the disease, 
the indications of treatment are, to equalize the circulation, re- 
store the natural warmth of the system, cleanse the stomach by 
emetics, the bowels by enemas, and strengthen digestion. A 
physician by long experience in the use of the stethoscope, may 
be enabled to form a very accurate opinion in relation to diseases 
of the heart. This kind of knowledge, however, does not teach 
us how to cure disease. A man may be a perfect anatomist, and 
yet be a very unsuccessful practitioner. A knowledge of the 
construction of the human system, and a knowledge of the laws 
of life are so distinct, that the one may be understood, without 
any correct know ledge of the other. 



CHAPTER XV. 



SECTIO??- I. 

BLEEBLXG FROM TEE LU.YGS. 

Raising blood from the lungs occurs under various conditions 
of them, and although it generally occasions alarm, it is not 
always attended with danger. Though generally connected 
with pulmonary consumption or with a predisposition to that 
disease, still frequent instances have occurred whei'e persons 
have been subject to bleeding from the lungs, for many years, 
without much inconvenience ; and, occasionally persons live to 
an advanced age who have been subject to these frequent dis- 
charges of blood. 

The opinion so generally prevailing, that bleeding from the 
lungs is always caused by the rupture of a bloodvessel is erro- 
neous. Still this does occasionally happen, in the advanced stage 
of consumption in consequence of ulceration of the vessels. But 
in the great majority of instances the blood oozes through the in- 
finitely small vessels which terminate on the lining membrane of 



318 BLEEDING FROM THE XUNGS. 

the air passages ; these vessels heing in a relaxed, or otherwise 
diseased condition, are unable to resist the pressure of blood upon 
them. The same occurs in the lining membrane of the nose : the 
blood escapes from the mouths of the vessels without their being 
ruptured. The quantity of blood discharged varies greatly in dif- 
ferent individuals ; and, also at different periods, in the same 
patient. 

A free discharge of blood from the lungs is usually preceded 
by coldness of the extremities ; a sensation of tightness and op- 
pression at the breast ; distress at the pit of thestoniach ; palpi- 
tation of the heart ; chilliness; agitation of mind ; *' alternate 
paleness and flushing of the face ; and often a disagreeable salty 
or sweetish taste in tlie mouth." 

To distinguish bleeding from the lungs, from bleeding from the 
stomach : observe that where blood is vomited it comes from the 
stomach ; and when raised by haucking or coughing it is from 
the lungs. 

Causes. — Bleeding from the lungs may arise from various 
causes, such as, the presence of tuburcles in the lungs ; exposure 
to cold and dampness; over-exertion ; disordered stomach ; *'the 
suppression of habitual evacuations; and obstructions in the 
liver, or spleen." 

Mar ehj iwoves fatal. — Patients seldom die of bleeding from the 
lungs ; for although tlie bleeding may be profuse, it is seldom 
so great as to endanger life. Frequent copious bleeding from 
the lungs, however, may occasion such a degree of debility and 
coldness of the system, that dropsy, consumption, or marasmus, 
Avill ensue, and which may prove incurable. 

Treatment. — The important indications for checking the es- 
cape of blood from the lungs, is to equalize its circulation through- 
out the system. An uiidue accumulation of blood in the lungs is 
always attended by a corresponding deficiency in otlier parts. 

In cases of slight bleeding, placing the feet in water as hot as 
can be borne and drinking freely of hot composition tea to excite 
perspiration, and assist in equalizing the circulation, may be suf- 
ficient to check the bleeding. But where this is not sufficient, a 
full course of medicine administered will prove the surest means 
of equalizing the circulation. If the patient be very feeble hot 
bricks wrapt in damp cloths may be kept at tlie feet, in place of 
the vapour bath; and a prompt emetic given. I have never wit- 
nessed a case in which bleeding from the lungs continued, after 
the free operation of an emetic. The lobelia sliould be given 
freely, not only with tlic view to produce free vomiting but also to 
relax the system. Stimulating injections containing lobelia, are 



BLEEDING FROM THE LUNGS. 319 

especially benefUual, by the influence which they exert in deter- 
mining the blood from the lungs. The patient must be kept 
quiet as possible, and avoid conversation. After the bleeding is 
ciiecked the warm application to the feet should be continued, to- 
gether with an occasional dose of composition to maintain an 
equilibrium in the circulation; and if the patient be feverish, or 
restless add such a portion of the tincture of lobelia to the compo- 
sition as will merely occasion slight nausea. Bayberry and su- 
mac berries stee})ed in boiling water making a very strong tea, ad- 
ding ajjortion of cayenne, sweetened, and drank freely, will be as 
effectual a remedy as can be taken, excepting the emetic. Profes- 
sor Chapman in his lectures, relates the circumstance of his 
being called to attend a young man who w^as bleeding freely from 
the lungs, and as the doctor entered the room the patient vomited 
in consequence of a large dose of medicine that he had just taken, 
and the bleeding immediately ceased. The fact of the hemorrhage 
from the lungs ceasing when the patient vomited together with the 
conviction that it admitted an easy explanation, induced the doc- 
tor to make a trial of emetics in similar cases. Accordingly in 
the next case that came under his care, which was that of a 
young woman who was bleeding profusely, and the usual means, 
salt, and acetate of lead, having failed, an emetic of ipecacuanna 
w^as given, whieh produced active vomiting, and the bleeding im- 
mediately ceased. The next case of the kind was that of a young 
w^oman who had been subject to raising blood, in consequence of 
suppression of menses. The usual remedies having also failed, 
the doctor resorted to an emetic, and with entire success : not 
only did the emetie check the flow of blood from the lungs, but 
it removed the obstruction which occasioned the bleeding. Dr. 
Chapman declares that more than thirty years experience has 
convinced him that emetics are the most effectual means for 
checking bleeding from the lungs : rarely ever failing, and 
no danger attending the operation, when under the direction of a 
judicious practitioner. 

In the advanced stage of consumption or v. hen there is extreme 
prostration of strength, the patient should not be subjected to 
over-exertion, either by getting up, or by conversation. It is in 
cases unconnected with deep consumption, that a thorough course 
of treatment will be more appropriate. 

Persons not in deep consumption who are liable to attacks of 
raising blood from the lungs, by taking an emetic or a full 
course of medicine, as soon as there are symptoms which indicate 
approaching hemorrhage, it will in almost every instance prevent 
the bleeding ; and this will not only be a means of preventing 
hemorrhage at the time but will also prove the most effectual 
means of restoring the general health, and thus remove the pre- 
disposition to raising blood. 



320 EPISTAXIS. 

Common table salt is a remedy generally resorted to for spit- 
ting blood, which together with placing the feet in warm water, 
will sometimes be successful in stopping the bleeding. 

In bleeding from the stomach I have found emetics to be suc- 
cessful in checking the hemorrhage. When the stomach is dis- 
tended by an accumulation of blood, or other substances, the 
bleeding may continue until the stomach is relieved of its op- 
pression, by a prompt emetic, and stimulants given to excite it 
to contract. On several occasions I have administered the liquid 
of the tiiird preparation of lobelia in a strong decoction of the 
bayberry, or sumac, which has invariably succeeded in 
checking the bleeding after vomiting has occurred. The vapour 
bath, and injections to the bowels are as much indicated in bleed- 
ing from the stomach as in hemorrhage from the lungs. 



SECTIOJSr II. 



EPISTAXIS. 



(bleeding erom the ]!«^0SE.) 

Bleeding from the nose, as it usually occurs in young and 
liealthy persons; or where it is caused by slight injuries, does 
not require particular attention. Conlirmed into a habit, how- 
ever, it is liable to bring on disease of the lungs, by its draining 
the system of so much blood. 

Bleeding from the nose often takes place during the active 
stage of fever, and more especially when it is attended with great 
fullness of the head. 

From the frequent occurrence also of bleeding from the nose 
about the turn of fever, it is considered by many as a crisis 
symptom and has been cited as an argument in favour of blood- 
letting in fever; but it should be recollected that the escape of 
blood from the nose is the effect and not the cmise of the favour- 
able change in the disease ; the vessels of the mucous membrane 
of the nose being debilitated by disease, are unable to resist the 
force of the circulation, when it is restored to these parts, by the 
increase of vital power. 

Bleeding from the nose occurs in a condition of the system the 



EPISTAXIS. 521 

opposite to that above mentioned, namely: in the sinking stage 
of malignant diseases, as typhus and yellow fever: the blood ap- 
parently becoming dissolved and deprived of its tenuity, escapes 
from the vessels, they having lost their power of contraction. — 
This is an unfavourable occurrence, as it tends to reduce the 
already enfeebled strength of the patient. 

Occasionally bleeding from the nose assumes a serious aspect 
where it occurs in aged persons, and where there exists exten- 
sive derangement in some important organ, as the stomach, 
liver, spleen, &c., sometimes proving, under such circumstances, 
extremely difficult of control. 

Enormous -quantities of blood are sometimes lost from the 
nose. From five to eighteen, and even thirty pounds have, in 
some instances been lost in a few days. The bleeding it is said 
always ceases when the patient faints. 

Treatment — Persons predisposed to bleeding from the nose, 
should be careful to avoid all exciting causes, as exposure to 
cold, especially cold damp feet; heavy lifting, stooping with the 
head low, hot stove rooms, &c. 

The indications of treatment in this are the same as in bleed- 
ing from the lungs, namely: to equalize the circulation, and give 
tone to the vessels from which the bleeding proceeds. 

In its milder form, and where remedial means are deemed ne- 
cessary, placing the feet in warm water, bathing the face in 
cold vinegar and water, or whiskey and water, and taking a 
dose or two of composition or pe])per tea, will be sufficient. 

Stimulating injections, containing a portion of lobelia will al- 
w^ays be found beneficial, and in obstinate cases almost indis- 
pensable. 

Pressing the sides of tlie nose togetlier with the thumb and 
finger, opposite the bleeding vessels, will in common cases prove 
effectual, provided the pressure be continued a sufficient length 
of time to allow the blood to coagulate and block up the vessels. 

If the pressure be made below the bleeding vessels tlie blood 
will pass down the nostrils into the throat, the hemorrhage not 
being checked. 

In cases of a more obstinate character, depending upon ex- 
tensive derangement of the general health ; or where it has be- 
come a confirmed habit, a course of medicine should be re- 
peated at proper intervals, together with proper intermediate 
treatment, with injections, and the usual means employed by 
Thomsonians for improving the health. 

The following is from Dr. Samuel Thomson's narrative. — 
'' While at Exeter, I had a case of a young man, son of Col. N. 
Oilman, who was in a decline. He was about fourteen years 
old, and had been troubled with bleeding at the nose. They had 

2Q 



S£2 BLEEDING FROM WOUNDS. 

made use of sucli powerful astringents, ^Yith corrosive sublimate 
snuffed up the nose, that the blood vessels in that part seemed 
to be shrunk up, and his flesh much wasted away ; I carried him 
through a course of medicine which caused an equal circulation of 
blood throughout his body, then raised a natural perspiration, and 
restored the digestive powers so as to support the body with food 
instead of medicine. The bleeding from the nose ceased and in 
a short time he recovered Iiis health." 

When bleeding from the nose occurs in an exhausted state ol 
the system, with cool skin, flesh soft and flabby, and the counte- 
nance pale, besides the employment of means for equalizing the 
circulation of the blood, stimulating and astringent applications 
should be made to the bleeding vessels to excite them to con- 
traction. No. 6, or the third preparation of lobelia, adding a 
portion of bayberry, may be introduced into the nose by means 
of a piece of cotton and a probe. 

Burned Cork, — It is said that a quill filled with the ashes oj 
burned cork and the ashes blown into the nostril immediately 
after cleaning out the clotted blood, has succeeded in arrestins 
bleeding from the nose in some y^vj obstinate cases. 

Spirits of Turpentine. — When bleeding from the nose occurs 
in what is termed typlius fever, the following is a good remedy 
a teaspoonful of spirits of turpentine beat up with the yolk of ar 
egg, and a teaspoonful of this given at a time to the patient re 
peating every ten or fifteen minutes. Occurring, however, in thi 
•sinking stage ef malignant forms of disease, when the blooc 
has become apparently dissolved or deprived of its fibrin, bu 
little benefit is to be anticipated from any remedy. 



SECTION III» 



BLEEDING FROM WOUNDS. 

Cuts made by a sharp edged instrument, bleed more thai 
wounds of the same or even much greater extent, made by i 
rough edged instrument, a saw for instance; or when with th 
cut the parts are much bruised. 

J^ature^s method for stopping the flow of Mood. — When ai 
artery or vein is divided the surface of the inner coat of the ves 



BLEEDING FROM WOUNDS. 323 

sel commences, throwing out a gluey substance which gradually 
fills up the cavity of the vessel, and prevents the further escape 
of blood. In this way the cavity of the vessel becomes gradu- 
ally filled so that in the course of half an hour an artery or vein 
the size of a small crow quill may entirely cease to bleed. — 
When a vessel is torn or bruised its cavity becomes closed much 
sooner than when it is cut with a smooth instrument. Lacerated 
wounds seldom bleed long; and sometimes very extensive wounds 
of this kind are attended by xery little bleeding from the com- 
mencement, even when large vessels are torn asunder. 

Wounds about the extremities or in any part where the vessels 
are not larger than a crow quill seldom requires the vessels to be 
taken up and tied, as the vessel will become plugged up in the 
manner above described, without any serious loss of blood, pro- 
vided advantage be taken of position and pressure used. 

Fositioii. — In wounds of the extremities, for instance, on the 
hand or arm, that bleed freely the parts should be held above 
the head ; or if on t!ie foot or leg, the patient should lie down 
and have the limb raised higher than tlie body. 

Pressure. — Much may be done by pressure in arresting bleed- 
ing, more especially where the cut vessel is situated in bony 
parts, for here the pressure will be more effectual. Pressure 
may be made by a piece of sponge, or a compress of folded cloths 
held or bound firmly upon the parts, until the bleeding ceases. 

When an artery is cut the blood will be thrown out in jets and 
its colour will be red ; whereas when a vein is cut dark blood is 
discharged. 

Large veins maybe checked from bleeding freely, by applying 
firm pressure on the vein above and below the wound. There 
is more or less danger to be apprehended from tying a vein ; this 
therefore is to be avoided, unless the vein be large and the bleed- 
ing cannot be checked by other means. 

Large arteries that are cut require a ligature, unless the bleed- 
ing should not be very profuse. A person in full health may 
lose large quantities of blood, and soon have this loss restored 
provided his digestion be not destroyed by the loss of blood.; 
Whereas in disease where the digestive functions are prostrated 
the loss will not be restored, for a much greater length of 
time; for new blood cannot be formed without chyle, and chyle 
is formed from food that is passing through the process of di- 
gestion. 

Vessels on the head seldom require tying, as pressure can be 
effectually made upon them in consequence of the vessel lying 
near the bones of the head. Tying the vessels on the head is 
also apt to be followed by erysipelas provided the parts have been 



324 BLEEDING EROM WOUNDS. 

bruised, unless great care be taken to protect the parts from the 
air. 

An artery that is only partly cut off will bleed much longer 
than when it is completely divided. Hence when it is ascertained 
that a vessel is partly divided it should be entirely severed, 
which will enable the ends of the bleeding vessel to contract and 
retract and to become filled up by the lymph which exudes from 
the inner coat of the vessel. If an artery Or vein be partly di- 
vided only, it will be difficult for the vessel to become filled 
with lymph, so that even a small artery that is partly cut in two, 
may continue to bleed a long time. The only means of ascer- 
taining whether a vessel be partly divided is by searching at the 
bottom of the wound by clearing away the clotted blood, and 
then applying a sponge to cleanse the wound so as to seize the 
vessel with a pair of forceps, and if it be found to be partly cut 
olF let it be entirely divided. 

Some surgeons recommend pinching and twisting the ends of 
bleeding vessels with a pair of forcejjs or tweezers, which cause 
the inner coat of the artery to throv/ out lymph more rapidly, 
filling it much sooner than would have been accomplished w ithout 
this measure. 

When persons lose so much blood as to cause fainting, the 
bleeding generally ceases. Relaxing the system by giving lo- 
belia, even though active vomiting occur, is an effectual method 
of checking bleeding from the uterine organs. Dr. Chapman 
mentions his being called in consultation with the late Dr. 
Physic, in a case of hemorrhage from the uterus, which having 
assumed an alarming character, all the means usually resorted 
to by the profession iiaving failed, Dr. Chapman from witness- 
ing the effects of vomiting in other forms of hemorrhage, deter- 
mined on trying the experiment of giving an emetic, W'hich re- 
sulted in effectually checking the bleeding. 

In another case of a lady from a distance, who vras subject to 
uterine hemorrhage, the discharge of blood becoming so profuse 
as to endanger her life, consulted Dr, C. who instituted a 
course of emetics, with the happiest effect. On being threat- 
ened with an attack of bleeding she commenced with the emetics 
and took six in eight days. The hemorrhage was checked, men- 
struation returned, and her liealth w-as restored. 

In tlie unimpregnated state, where hemorrhage arises from a 
state of extreme exhaustion, from previous loss of blood, by 
which the blood has become thin and watery, scarcely possessing 
fibrin sufdcient to coagulate, then filling up the vagina w ith a 
sponge, or cotton or soft cloths should be resorted to in case the 
hemorrhage is not checked by other m.eans. 



CHAPTER XVI. 



SECTION I. 



CAjYCER, 

Cancer is a malignant disease, generally seated in the glands^? 
though no portion or tissue of the hody is altogether exempt from 
the liability to become diseased in this way. Thus the lips, 
tongue, skin, stomach, ovaries, uterus, and even the bones are 
subject to cancer. 

Cancer, like tubercles in the lungs, is the consequence of a de- 
fect of the living principle in the part, together witli a vitiated 
state of the constitution. A female in good health, receiving a 
bruise upon the breast, would soon recover from it, for if the flesh 
be so much injured as to destroy its vitality, the parts surround- 
ing it will take on active inflammation, terminating in suppura- 
tion, and after the matter is discharged, adhesive inflammation 
heals the parts. Or if the parts be merely weakened by the bruise, 
adhesive inflammation will produce a hardness of the part, which 
however, will disappear without the formation of matter. In a 
certain depraved condition of the constitution or defective organ- 
ization, a bruise upon the breast, instead of being removed by 
one of the methods above described, namely: by means of in- 
flammation, the part that is injured by the bruise does not take 
on inflammation but gradually becomes converted into a sub- 
stance which operates as a foreign body in the system, the 
efforts of nature being insufficient to remove it by inflamma- 
tion and suppuration; it becomes converted into cancer. 

Various kinds of tumors and indolent ulcers are often mis- 
taken for cancers. Cancer doctors and doctresses are very apt 
to apply tlie name cancer to indolent sores and swellings, in or- 
der to gain a reputation for curing tliem; or probably from an 
inability to distinguish between true cancer and disorders that 
are not of that character. 

It is observed that unmarried females and those who have 
never borne children, are most liable to cancer of the breast* 



326 CANCER. 

Cancel' of the Female Breast 

Symptoms — When first discovered, a cancerous tumour is 
usually about the size of a marble, and is extremely hard and 
moveable. The disease progresses very slowly, attended now 
and then with a sense of uneasiness in the part, but without in- 
flammation of the skin. " Sometimes the attention is first at- 
tracted to the bosom by a drop of bloody serum having stained 
the linen opposite the nipple, it having flowed from one of the 
lactiferous tubes. Sometimes a distinct and sharp pricking pain 
leads to the discovery of the swelling.'' 

There is rarely much pain felt in the part in the early stage 
of cancer, but after a time the patient experiences turns of exces- 
sive darting, or burning pains in the tumor, which are apt to oc- 
cur at intervals of about two weeks. As the tumor becomes 
painful it is observed to enlarge, but true cancer rarely ever be- 
comes larger than two or three inches in diameter, except when 
the .disease invades the whole gland, rather than commencing 
in the form of a distinct tumor. 

As the disease advances the paroxysms of pain become more 
frequent, and are often intensely severe as though '^ the parts 
were pierced with a knife or the nerves of the breast torn out.'^ 
*< Prior to menstruation (about four days) the breast feels fuller, 
heavier, and much more painful. 

After the tumor has attained a considerable size, which in 
some instances requires many months or even years, the nipple 
is observed to become shorter, being drawn in by the milk ducts, 
which are pushed out of their course by the tumor ; *^ frequently 
also the nipple becomes red, inflamed, excoriated, and sometimes 
ulcerated." A change is also produced in the appearance of the 
skin ; it is puckered so as to resemble a cicatrix, and this arises 
from its adhesion to the surface of the cancer." At this stage 
of the disease the parts around the cancer become more firm and 
harder than natural and little tumors are generally perceptible 
in the parts surrounding the cancer. During the progress of 
cancer the glands under the arms almost always become more or 
less swollen and hard. 

*' Exists for years without destroying life.'^ — Months, and 
sometimes years roll on, and the disease continues in its adhesive 
stage: and it may even destroy life without ever suppurat- 
ing ; but frequently it proceeds to a suppurative inflammation : 
then the skin appears of a livid redness ; the pain becomes even 
more severe ; a slight sense of fluctuation, or rather of yielding, 
is perceived in the part, wliich gradually ulcerates and dis- 
charges only a bloody serum ; for true pus is not generated. — 
Pus is attempted to be produced ; but it is not formed on a truly 



CANCER S27 

malignant surface, but only upon the surrounding parts if they 
be ulcerated." Cooper, 

<^ Character of the sore. — The surface of the sore feels hard, 
like the original tumor, and is remarkably insensible to pressure; 
and you therefore will observe the patient wipe it and handle it 
with a degree of roughness and want of gentleness, which sur- 
prises those who are unaware of its little sensihility." {Cooper,^ 

Cancerous ulcers are apt to bleed frequently. The bleeding 
may be checked by a compress of carded cotton, lint, or soft 
muslin cloths, applied to the part and confined by a bandage, 
so as to make moderately firm pressure upon the bleeding ves- 
sels. As the ulceration proceeds a deep cavity is formed, some- 
times extending to the breast bone. 

Patients affected with cancer are apt to complain of rheumatic 
pains in various parts of the body more particularly in the loins 
and thighs. 

As the disease extends, the arm upon the diseased side becomes 
sw^ollen ; there is frequently much difficulty in breathing, the 
patient being unable to lie down ; a sense of stricture and spasms 
at the pit of the stomacli, is often experienced, and sometimes at- 
tended by vomiting. Finally the constitutional energies become 
exhausted and the patient sinks under the disease. 

It should be recollected, however, that it is not every case of 
cancer that destroys life, even when the tumor is not removed. 
Sometimes the disease remains stationary for many years. 

The female breast is very liable to tumors that do not par- 
take of the cancerous nature. A cancerous tumor in the breast 
is rarely ever observed in females under thirty years of age. 

Treatment — The chief indication in the treatment of cancer 
is the employment of such means as are best adapted to improve 
the condition of the general health. An occasional course of 
medicine, together with the daily use of stimulants — cayenne, 
composition, or spice bitters, and broken doses of lobelia in pill or 
tincture, given every two or three hours constitute the remedies 
principally to be employed in the way of constitutional treat- 
ment. 

If there be acidity of the stomach, and the bow^els costive, pur- 
ified charcoal will be beneficial. It may be taken prepared in 
composition or spice bitters tea. The dose of the charcoal is a 
large teaspoonful ; to be repeated two or three times a day be- 
fore meals. 

When a violent paroxysm of pain comes on, it may be miti- 
gated by the use of the warm foot bath, or of the vapour bath, 
and the use of enemas composed of some mild stimulant, such 
as weak composition or pennyroyal tea, with the addition of a 



328 CANCER. 

teaspoonful of lobelia, either the powder, tincture or third pre- 
paration. 

Whatever tends to equalize the circulation of the Mood, and 
of the nervous power, will relieve pain, no matter where it he 
situated. The free use of pure stimulants, cayenne and compo- 
sition, containing small portions of lobelia, will also be useful in 
relieving paroxysms of pain. 

Difficulty of breathing will be relieved by the treatment above 
mentioned. The same remedies are also indicated for the relief 
of the dry and harassing cough which often attends cancer, 
more especially in its more advanced stages. 

Tonics will be proper with a view to strengthen digestion — 
such as spice bitters, halmony, &c. 

Diet — ^^ It is supposed that a vegetable diet, and food afford- 
ing little nourishment is conducive to recovery. There is no 
greater mistake. Whatever weakens leads to an increase of the 
disease, and to a more rapid termination of the existence. Low 
living, renders the person irritable, quickens the pulse, and 
makes the constitution feel the disease more strongly. Vegeta- 
ble diet has not the least beneficial influence over this com- 
plaint.'^ — Cooper^ s Lectures* 

Applications to the Tumor, — During the earlier periods of 
cancerous tumors they should be kept warm, and the skin in a 
perspiration, by the application of some simple kind of salve 
spread on silk oil cloth, or by wearing a piece of rabit skin with 
the fur side to the breast. 

Poultices are to be applied when the tumor softens and the 
skin becomes inflamed. The poultice may be made of elm, gin- 
ger, and cracker, or any soft emollient substance, adding a por- 
tion of ginger, to render it moderately stimulating. 

Local Treatment for Open Cancer. 

Cancer, — Many reputed cures for cancer have been introduced 
into use in the form of salves, plasters, and balsams, but which 
upon the whole have doubtless been of far more injury than bene- 
fit. Powerful caustic and corroding poisons, as preparations of 
arsenic, are applied by some cancer doctors, to almost every 
kind of indolent ulcer they meet with, and if it should heal, it is 
announced as a case of cancer cured; whereas in true cancer such 
applications would probably have little effect other than to irri- 
tate the parts and aggravate the sufferings of the patient, with- 
out accomplishing a cure. 



CAJJ-CER 



32^ 



Extract of Sheep Sorrel. — The use of this article, appears to 
have operated very favourably in some cases of cancer. The 
extract is obtained by evaporating the juice of the sorrel, in tin 
or pewter plates set in the sun, until it acquires the consistency 
of tar. This is spread on thin leather or silk oil cloth and ap- 
plied to the cancer, renewing it daily. 

Extract of Red Clover Blossoms. — Tliis preparation is recom- 
mended by Dr. Tliomson as a valuable application in cases of 
open cancer. I cannot speak from personal knowledge of the 
Cificacy of this remedy. 

Caustics. — Small cancers situated in the skin, as in cancer of 
the lip, the frequent application of the caustic potash, or lunar 
caustic, may succeed in removing them. After each application 
of the caustic, an emollient poultice or mild salve may be ap- 
plied. 

Lounsherrtfs Plaster. — A Baptist minister, by the name of 
Lounsberry, residing in Connecticut, prepares a plaster which 
appears to be gaining considerable reputation as a cure for can- 
cer. I have witnessed the effects of this plaster in but one case 
of cancer, and I must say that I was much surprised and grati- 
fied at the effects produced. 

The Case. — Mrs. Harding, residing in Second street, had a 
true cancer in her right breast, for which she had consulted the 
principal surgeons in the city, one of which advised its removal 
by an operation, whilst ^every other one that she applied to told 
her it w^as too late to operate. I had examined this tumor every 
week or two, during a period of two years after it had become 
an open cancer. Various kinds of plaster were employed, with- 
out effecting any change for the better. On the application of 
the plaster above mentioned, the cancer began to assume a dif- 
ferent aspect, and in the course of a few weeks, a distinct divi- 
sion took place between the cancer and the living flesh, and 
finally the whole of the cancer came away, leaving a cavity, the 
surface of which had a healthy appearance. 

Several months have elapsed since this cancer was removed, 
and although the parts are not entirely healed, yet there is no 
appearance of a return of cancer in the part. In this case, how- 
ever, as it often happens in cancer, the constitution is contami- 
nated with the disease, there having been for two years past 
symptoms indicating the existence of cancerous tubercles in other 
parts of the body, and which must eventually terminate fatally 
to the patient. 

I do not know the composition of Lounsberry's plaster, yet I 
have observed that when it is applied to a raw surface, it does 

2Q 



1 



330 INFIAMMATIOK. 

not corrode or even occasion inflamn^ation. This plaster is 
much less painful to the parts than cancer plasters are in ge- 
neral. 

I should not recommend a secret medicine designed to be 
taken inwardly, but as this plaster does not appear to possess 
any deleterious quality, I should not hesitate to employ it. If 
there be a cure for cancer it ought to become universally known. 

With regard to the removal of cancer by the knife, it is cer- 
tainly less objectionable than to have it destroyed by the appli- 
cation of caustic, unless the cancer be very superficial, and even 
then the knife would be less painful than caustic. 

Cancer depending in the great majority of instances upon con- 
stitutional disorder, is seldom effectually cured by an operation. 
In four cases out of five the disease breaks out in another part 
of the body in the course of a year after a cancer has been thus re- 
moved. Cancers situated in the skin may be eftectually re- 
moved either by the knife, by the application of plasters, or by 
caustic, and sometimes the disease does not return even where 
the seat has been in a gland, for instance, in the breast. 



CHAPTER XYL 



SECTION I« 



INFLAMMATION. 



Inflammation is a restorative action instituted hy the con^ 
stitution to heal wounds, repair injuries, and to remove extrane-^ 
ous bodies lodged in the flesh. Thus if a bruise be inflicted upon 
a part, an inflammatory action is established to restore the part to 
a healthy condition; wounds are healed by the same means; if a 
splinter be lodged in the flesh inflammation is established by 
which matter is formed around the splinter, separating it from 
the living parts. 

A wound cannot heal without inflammation, except in case of 
a smooth cut by a sharp instrument, and the wound be immedi- 
ately closed so as to exclude the admission of air into it. In 
order to repair an injury, the part must receive a greater sup- 



INFLAMMATION. S3 1 

ply of blood than is natural to it when in a healthy condition. 
The hlood furnishes the substance that unites wounds. 

"Inflammation may be considered as a genns, of which there 
are many species. It may be divided into healthy and unhealthy. 
The healthy is that which will always take place in a healthy 
constitution or part, and is rather to be considered as a restora- 
tive process tlian a disease. Unhealthy inflammation is that 
which takes place in an unhealthy constitution or part, and will 
vary according to the kind of unheal thiness of that constitution 
or ^arV— Hunter. 

A wound that heals readily in a healthy constitution may in a 
vitiated or disordered condition of the health become a very 
troublesome and protracted sore. If a person in good health re- 
ceive a bruise, so severe as to destroy the vitality of a portion 
of flesh, the first step which nature takes for repairing the in- 
jury is to direct an increased supply of blood to the part, and set 
up an inflammation in the injured parts, occasioning increased 
heat, with redness and swelling. The inflammation causes the 
cells of the cellular tissue to become blocked up, which prevents 
the disease from spreading to the surrounding parts. The flesh 
feels firm, and the swelling is circumscribed, as is observed in 
the case of a common bile. The next point is to remove the por- 
tion of flesh which was killed by the bruise. This is accom- 
plished by means of an inflammatory action, converting the 
parts immediately surrounding the dead flesh into pus or matter, 
which separates the dead from the living flesh; the pus finds its 
way to the surface and is discharged. The parts having become 
freed from the dead flesh, the next step is to heal the cavity. — 
This is also accomplished by an inflammatory action; granula- 
tions are formed on the sides of the cavity, by which the parts 
are united. In case of a bruise that does not kill any portion of 
the flesh, an inflammatory action is established, and the coagu- 
lable lymph supplied by the blood is difl*used through tlie cellu- 
lar tissue rendering the parts more or less swollen and firmer 
than natural, but no pus will be formed; the swelling and hard- 
ness gradually subsiding until the parts are restored to a healthy 
condition. Wlien a person is stung by a bee, nature quickly 
brings on inflammation, in order to block up the cellular tissue 
around the poisoned part, and thus prevent the poison from be- 
ing absorbed, or extending further. A broken bone cannot 
unite without inflammation. Cases have occurred where broken 
bones have not united by bony union, in consequence of 
the broken parts being frequently subjected to motion, breaking 
up the knitting of the bone, until finally the inflammation has 
subsided, and the parts not being supplied with sufficient blood 
to furnish material, and sustain the action necessary to unite tI>o 
broken bone, a false joint is formed. 



332 INFXAMMATIOW 

Dr. Physic devised a plan for effecting a reunion of the bone 
in such cases, by forcing a threaded needle through the limb, 
between the surfaces of broken bones, and leaving the thread in 
the part for the purpose of exciting inflammation, and thus fur- 
nishing the means necessary for a reunion of the bone. 

Although inflammation be a restorative or healthy action, it is 
liable^to become perverted into an unhealthy one, or at least the 
constitution may fail of accomplishing the design of inflammation. 
Thus if a person of scrofulous constitution, or whose system is 
in an otherwise unhealthy condition, should receive a bruise 
"which destroys the vitality of a portion of flesh, the inflamma- 
tion that ensues will be extremely liable to assume an unhealthy 
character, theefTorts of naturebeingtoo feeble to establish healthy 
inflammation, and instead of being circumscribed as in case of a 
bile, it may spread over a considerable extent of surface, form- 
ing what is called erysipelas; and when matter is formed in the 
injured part, instead of being confined to the spot where it is se- 
«reted, as it is when the intiammation is of a healthy character, 
it spreads to a greater or less extent through the surrounding 
parts, which become swollen, doughey, and without extra heat 
attending, and may require a long time for the parts to become re- 
stored to a healthy condition in consequence of the want of power 
in the system to establish an efficient iniiammatory action. A 
simple incision in the flesh from a sharp instrument, that heals 
rapidly in a healthy constitution, may become converted into an 
indolent ulcer in one of an unhealthy constitution. An injury 
upon the skin, that would be followed by healthy inflammation, 
and the part restored to a healthy condition in a short time in a 
young man would be apt to become converted into an indolent 
ulcer, and probably continue for years in an old man in feeble 
health. The healing power is sometimes almost destroyed in 
constitutions poisoned by the use of mercury: the simple scratch 
from a pin, causing a long continued running sore. Blisters 
have occasionally been observed to become gangrenous, in conse- 
quence of extreme prostration of the healing powers of the sys- 
tem; the constitutional energies becoming^too far exhausted to 
establish healthy inflammation, and to sustain the action neces- 
sary to heal the parts. Inflammation may assume an unhealthy 
character in consequence of the severity of an injury — destroy- 
ing almost the vitality of the surrounding parts. This fact is 
frequently noticed in gun-shot wounds, the parts surrounding 
tlie wound being deadened, the vessels of the parts have not suf- 
ficient power to carry on a healthy inflammatory or restorative 
action. 

Inflammation in internal organs is no less curative in design, 
than w hen it is confined to external parts of the body. Poison 



IlfrLAMMATIOir. 535 

taken into the stomach is followed by inflammation of its mucous 
membrane, unless the dose be so large as to destroy the vitality 
of this organ. The direct tendency of poison is to destroy 
the principle of life, and inflammation is the means which nature 
employs to counteract the effects of the poison and preserve the 
life of the parts. Tlie inflammatory action existing in the mu- 
cous membrane of the stomach in those forms of disease called 
fevers, is the restorative power of nature in action. No person 
ever recovered from a low form of fever ^vitilout some degree of 
inflammation having existed in the stomach. In inflammation of 
the stomach medicine should be given that will excite the secre- 
tions, for which there is no article superior to cayenne pepper. 
Inflammation of the throat is relieved and its efforts aided hy 
gargling ^vith pepper tea, whicli excites the secretions and re- 
lieves the congested vessels. It is ascertained that the mucous 
membrane of the stomach seldom exhibits marks of inflammation 
when patients die soon after an attack of some highly malignant 
form of disease, for instance, yellow fever: the force of the cause 
of disease having suddenly prostrated the living principle so low 
that the constitution is unable to establish an inflammatory ac- 
tion. I have invariably employed cayenne pepper tea in every 
variety of fever, attended with symptoms of inflammation of the^ 
stomach, and have never observed the inflammation to be aggra- 
vated by it. Inflammation on the surface of the body may re- 
quire cooling applications, to lessen the determination of blood 
to the parts; whereas inflammation in a secreting surface, like 
that of the mucous membrane of the stomach, require stimulants 
such as are used by Thomsonians, which restore the secretions. 

Spontaneous Infiammation. — In tlie common form of bile, we 
observe an instance of spontaneous inflammation. The inflam- 
mation is not less a curative action when it occurs spontaneously 
from constitutional causes, than when it occurs after local in- 
juries. In small pox, the inflammation attending the eruption is 
the curative action of the system. It has been observed univer- 
sally, that where small pox pustules are distinct and surrounded 
by a well developed inflammation, that there is but little ground 
for apprehension of danger; but w^hen the eruptions are sur- 
rounded by an imperfectly developed inflammation, or the inflam- 
mation assumes an unhealthy character — being converted into 
erysipelas, there is great danger of an unfavourable termination 
of the disease, or at least that the efforts of nature will prove in- 
sufficient to eradicate the disease effectually from the system, 
thus leaving the patient affected with chronic symptoms. 

When a dentist applies arsenic to the nerve of a decayed tooth, 
at first there will be a sensation of coldness in the part, which 
will soon be followed by pain and inflammation; tlie inflammation 



bb^ INFLAMMATIOIC. 

is necessary to prevent the deadening effects of tlve arsenic from 
extending further along tiie nerve: by establishing a division 
line between the live and dead portions of the nerve. 

If a person have his foot pierced hy a nail, followed byinflam- 
malion in the part and some discharge of matter there is sel- 
dom any danger to be apprehended; but if the wound be deep and 
closes without there having been inflammation in the part, means 
should be taken to excite inflammation in the wound, otherwise 
the patient will be more or less liable to lockjaw. 

Case. — A young man residing in Trenton, N. J., received a 
few weeks since a severe injury in the hand by the discharge of 
a gun. The wound was dressed with emollient applications, 
and it exhibited no marks of inflammation even after the 
lapse of several days from the time the injury was inflicted. At 
length the patient was seized v*ith lock jaw and died in the 
course of two or three days after; the injured part not liaving been 
at any time sore or inflamed. 

**Let us suppose that two women receive each a blow on the 
breast, one with a healthy and vigorous constitution, and the 
other with a system worn down with care, anxiety and disap- 
pointment, and in a constant state of chronic feverish excitement 
in which the secretions are imperfectly performed, and is thus 
predisposed to the formation of cancer: in the first individual, the 
inflammation produced will be strictly healthy, going through 
its different stages, until the cure is accomplished; but in the 
other, owing to constitutional peculiarity, the same extent of in- 
jury will produce cancerous disease; an affection over which all 
remedies hitherto tried have little control, and extirpation is but 
an uncertain mode of relief." Cooper^s Lectures. 

Inflammation sometimes occurs on the extremities of aged per- 
sons in consequence of debility. There being a tendencyto stag- 
nation of the blood in the parts in consequence of a want of power 
in the vessels; the constitution directs an unusual supply of 
blood there in order to give increased power to the vessels, and 
this effort is frequently attended by inflammation of the skin. 

Finally whenever nature is called upon to repair an injury, 
such as a bruise, cut, or wound of any description, or to over- 
come debility in a part, however produced, she performs the cure 
by means oHnJlammatioiu It must be borne in mind however, 
that the efforts of nature often require the aid of medicine and 
other means for the regulation and sustaining of lier restorative 
actions. Thus in a common bile there may^be an undue accu- 
mulation of blood in the parts, causing so much swelling and pain 
as to prove detrimental to the sanative inflammatory efforts. — 
Here means should be employed for lessening the determination 



iNflAMMATIO^. o33 

of blood to the part, facilitate its return to the heart, and to re- 
duce the external heat of the inflamed part when it is too high. 

Chronic Iiiflammation. — When inflammation fails of accom- 
plishing its object, and instead of coming to a crisis, becomes 
seated, it is termed clironic inflammation. Suppose that an in- 
dividual is attacked with erysipelas, and the inflammation in- 
stead of forming a crisis and disappearing in the course of a few 
days as it usually does, should become seated in the part, the ef- 
forts of nature being too feeble to restore the parts to a healthy 
condition; such would be termed chronic inflammation. Acute 
inflammation is often converted into chronic inflammation by im- 
proper treatment, weakening the power of action and thus frus- 
trating the designs of nature. 1 once saw a labouring man who 
lost the use of one of his hands in consequence I believe of the 
continued application of cold lead water to erysipelas. The in- 
flammation covered the back of the hand and extended up nearly 
to the elbow. Lead water w^as applied by the direction of a 
physician, and the application of it continued three weeks. The 
parts became so much weakened that the vessels apparently lost 
the power of action, the muscles became stiff" and rigid so that the 
hand became useless. It is not unlikely that this patient under 
a different course of treatment would have retained the use of his 
hand. 

TREATMENT OE INFLAMMATION IN GENERAL 

Constitutional Treatment When the general health is disor- 
dered inflammation is liable to assume an unhealthy character. 
Hence constitutional treatment is in many cases of the greatest 
importance as a means of curing inflammation: by aiding the ef- 
forts of nature. Thus if a patient in bad health receive a severe 
injury he should be carried through a course of medicine, repeat- 
ing it if necessary; together with the continued use of pure stim- 
ulants to sustain the secretions, and aid in equalizing the circu- 
lation, and promoting perspiration. Severe injuries always oc- 
casion more or less derangement in the system weakening 
the restorative power of the constitution, and increasing the lia- 
bility to the occurrence of unhealthy inflammation; erysipelas 
for instance. 

If an individual receive a severe injury, as a blow upon the 
head or fall from a height, soon after eating a full meal, his di- 
gestion will be s?ispended, and the imperfectly digested food will 
still further oppress the functions of the stomach and aggravate 
the symptoms. Under such circumstances an emetic should al- 
Avays be given no matter in what part the injury may be situated. 
There is no better form of emetic than the following. 



S36 INFXAMMATIO??'. 

A teaspoon fill of tlie third preparation of lobelia, and one of 
green lobelia powdered, adding a teacup two-thirds full of strong 
bayberry tea, sweeten and give at once, repeating the dose as 
often as necessary; if the injury be on the head, the emetic may 
be preceded by the warm foot bath or vapour bath, and an enema 
administered, with a view to determine the circulation to the 
bowels, and thus lessen the tendency to a great determination of 
blood to the head. Although an injured part requires a supply 
of blood greater than is necessary when that part is in a healthy 
condition, still there may be too great a determination of blood 
to the injury, or there may be too great a collection of blood in 
the part in consequence of the weakened state of the vessels, they 
being unable to return the blood by the veins into the general cir- 
culation. I doubt whether any intelligent physician, whose 
mind was not influenced by prejudice or warped by preconceived 
opinions, could witness the effects of a thorough Thomsonian 
course of medicine, without perceiving the philosophy of its ap- 
plication, in all cases of inflammation, wherever seated. 

The constitutional disturbance after severe injuries is some- 
times very great, requiring strict attention. The treatment for 
constitutional shocks or disturbances will be pointed out here- 
after. 

During the first stages of injlammationj if there be general fe- 
ver, or a dry and hot skin and foul tongue, or if the inflamed 
parts are very painful, or tlie patient restless and distressed, 
then, besides a course of medicine, the system should be relaxed 
by giving broken doses of lobelia, and occasionally a dose of 
composition or pepper tea, or of si.iiple herb teas, pennyroyal or 
ditany. 

The physician who asserts that sucli a course of treatment as 
I have just described, will aggravate inflammation, or have any 
other tendency than that of hastening its progress to a favoura- 
ble termination, has imhihQi\ false principles in medicine, instead 
of the truths of the science. 

The above course of treatment is not to be restricted to the 
first stages of inflammation; it is during tliis period that it is in 
general most required. It will be proper, however, during any 
stage of inflammation when the symptoms appear to demand it. 

"When you are required to take charge of patients suffering 
from an injury, which demands a length of time for its restora- 
tion, you must be exceedingly careful how you take away blood 
from the system generally, but must in preference adopt local 
bleeding; for if, as I have observed, you adopt a system of free 
depletion, nature will not be equal to the restoration of the in- 
jured parts, and the most disastrous consequences will follow 
the indiscriminate employment of blood-letting. There is not 



INFLAMMATION-. 537 

a greater error than this in the practice of surgery." Cooper's 
Lectures* 

The following case is related by Sir Astley Cooper, as an in- 
stance of the fatal consequence of over-bleeding. " A stout 
man was admitted into Guy's hospital, having a simple fracture 
of the tibia, with considerable contusion of the surrounding parts; 
a day or two after bis admission, he had severe constitutional irri- 
tation and acute pain, with spasmodic action of the muscles near 
the seat of injury. To relieve these symptoms, the dresser was 
directed to take some blood from tlie arm of the patient, which 
he did; but thinking it proper thatfaintness should be produced, 
as a proof of its effects upon the constitution, and forgetting that 
the patient was in a recumbent position, he abstracted so large a 
quantity of blood, that all power of restoration was completely 
annihilated and the man died." 

The above case is but one of thousands, and probably tens of 
thousands, whose existence has been cut short in this way. 

When an individual is badly hurt, it is the almost universal 
practice among physicians to bleed, under the impression that 
it will lessen the tendency to inflammation. So far as it relaxes 
the system and occasions perspiration, it may lessen the pain, 
and for the time present over excitement of the part, but there is as 
much probability of such a course of practice perverting the salu- 
tary efforts of nature, the inflammation consequently assuming 
an unhealthy character, as that it will lessen the tendency to vi- 
olent inflammation. The administration of a vapour bath will 
be attended with all the good effects that can result from bleed- 
ing, and without the liability to any of the danger consequent 
upon the loss of blood. 

Vapour Bath. — To restore the secretions of the skin is an im- 
important indication in the treatment of inflammation, whether it 
be seated in external or in internal parts. The administration 
of the vapour bath, togetlier with the use of pure stimulants, as 
capsicum or composition tea, and broken doses of lobelia, will 
restore perspiration and likewise excite the secretions of the mu- 
cous membrane of the stomach, which is equally important in the 
treatment of inflammation. These are remedies which harmo- 
nize with the living principle, and at the same time that they re- 
lieve the suffering of the patient, they aid the efforts of the con- 
stitution in repairing injuries. 

In the later stages of inflammation for instance, where there 
is a free discharge of pus from a part, and the patient is clear of 
fever, bitter tonics may be given. 

When the tongue is furred and manifests a tendency to clean 
around the edges, or the coating on the tongue softens, then the 
astringent, or anti-canker medicine should be employed occa- 

2 R 



538 iiSTFLAMMATIOm 

sionally, with the view of clearing the mucous surface of thes© 
morbid secretions, or canker. 

Diet — In the early stages of inflammation, and more especi- 
ally if the tongue be coated, or the general health deranged, the 
diet must he confined to such articles as require butpittle effort 
to digest them, snch as light gruels, toast and tea, barley water, 
rice, milk porridge, &c. It is better that the patient have a. 
scanty supply of food than to take such as the stomach cannot 
digest, for this will always operate against nature. It is not so 
much low living that is demanded, but it is the want of power to 
digest strong food that must be regarded. 

When the patient is in a relaxed condition with absence of 
fever, cleaning of the tongue, and a tendency to warm perspira- 
tion, the diet should be nourishing — eggs, custards, oysters, 
beef steak, mutton, wild game, bread and butter, and whatever 
the patient may fancy that does not disagree with the stomachy 
avoiding of course articles that are known to be hard of diges- 
tion, such as hot cakes buttered, sausages, sweet cakes, fresh 
pork, and corned beef. 

Of Exterfial applications in Inflammation. — In acute inflam- 
mation, attended with great heat and swelling in the parts, the 
application of cotton or soft cloths kept constantly damp with 
whiskey and water, or vinegar and water will afford relief. Al- 
though inflammation be a restorative action, still it often needs 
the aid both of internal and external remedies, to assist the con- 
stitution and the vessels of injured parts in regulating the in- 
flammatory action. A wounded part requires a greater supply 
of blood to repair the injury, than is sent to this part when in a 
healthy condition; yet without proper treatment there may be an 
undue accumulation of blood in the part, occasioning unnecessary 
pain and acting injuriously both upon the injured part and upon 
the general health. 

Foultices are useful in recent cases of inflammation, as in biles^ 
felons, severe bruises, and also in injuries where the flesh is 
much torn or lacerated. In pleurisy though the inflammation 
is seated in inward parts, still experience proves the utility of 
poulticing the affected side provided the poultice be kept warm. 
Slippery elm, white pond lilly, powdered cracker and ginger 
form a poultice adapted to all cases where there is inflammation. 

In erysipelas, and in all cases where an inflammation has been 
long continued, cold applications and emollient poultices are im- 
proper. Local steaming and stimulating applications are here 
required, to increase the power of the enfeebled vessels. It is in 
active inflammation, such as attends common biles and wounds 



IlfrLAMMATIOJf. SS9 

in healthy constitutions, that the use of external cooling remedies 
is indicated. 

Warmth and Moisture. — AYarm fomentations, and the appli- 
cation of steam or warm vapour, may be employed with safety 
in all cases of inflammation; and generally these applications af- 
ford relief even in acute inflammation, by exciting perspiration. 
In chronic inflammation, for instance, as it occurs on the legs of 
aged persons, stimulating applications should be applied either 
in the form of liniment, or poultice. 

Case, — During the summer of '39 I was called to visit an old 
lady residing in Y/ater street, who had chronic inflammation on 
both limbs, extending from the ankle joint to the knee, the parts 
being much swollen. The case was one of long standing, but 
was cured by steaming tlie limbs every two or three days, and 
covering the diseased parts with a poultice composed of the dregs 
of No. 6, slippery elm bark and white pound lilly. The poul- 
tice was spread on silk oil cloth in order to prevent evaporation, 
and to retain the heat. The patient also took composition pow- 
der in luke-warm water three or four times a day; and the feet 
were elevated npon a chair, when the patient was out of bed. 

Position. — When inflammation is seated about the head, it 
should be elevated above the level of the body; or, if it be seated 
on a limb, it also should be raised higher than the body. This 
lessens the determination of blood to the inflamed part, and by 
the aid of gravity favours the return of the blood from the parts 
inflamed. 

Case. — **I was sent for" (observes Astley Cooper) to see a 
gentleman farmer, in the neighborhood of Rayleigh, in Essex, 
wiio for a long time had been subject to a very severe inflamma- 
tion in both his legs; they were of a very dark red colour, much 
swollen, and gangrene was threatened in them; the constitutional 
irritation was great, and his tongue covered with a brown fur: 
when I saw him his legs were resting in a tub of cold water, and 
on his taking them out they smoked. I had him immediately 
placed on a sofa, and contrived to rest his legs upon one of its 
ends, so as to raise them mucli higher than his body; the vessels 
soon began to unload themselves, and in a short time the redness 
of the skin was much lessened; I then applied flannels, which had 
been dipped in tepid water, and afterwards in warm water; this 
produced a free perspiration, by which the skin became unloaded; 
the swelling and pain consequently diminished. He gradually 
recovered, and in six weeks was able to ride a considerable dis- 
tance. It would be absurd to attempt to cure extensive inflam- 



S40 SPRAlJ^S. 

mation in a litnbj if it were allowed to remain in a depending 
posture." 

In inftammation about the hand, for instance a felon or bile^ 
is rendered extensively painful by the hand being allowed to hang 
down. 

Rest, — During the active stage of inflammation the parts 
should be kept at rest; this is more particularly necessary in in- 
flammation of the joints. 

Pressure.-^In chronic inflammation of an indolent character^ 
more especially when accompanying abscesses, carbuncle for in- 
stance, benefit wdll be derived from pressure: by bandaging the 
parts or applying strips of adhesive plaster. Erysipelas some- 
times leaves the parts thickened and hard after the inflammation 
has subsided; here pressure will be required, to excite action in 
the absorbent vessels for the purpose of removing tlie swelling. 

Friction, — In chronic inflammation of the joints, rubbing the 
parts briskly, excites the circulation and is frequently followed by 
very marked benefit. 

In disease of the general system, /et^er is nature's hand-maid; 
in local diseases her chief dependence is upon hiflammation, — 
Hence in no case of fever or inflammation should we aim to sub- 
due or hreak down fever or inflammation, but to assist the ef~ 
forts of nature, by means which liarmonize with her established 
laws. 



SECTION II. 



SPRAINS. 



Sprains are caused by a sudden wrench or twisting of a joint 
by which the ligaments or tendons are either torn or violently 
stretched. 

The wrist and ankle joint are those most liable to sprains. 

Sprains are attended with severe pain at the time of the injury, 
w^hich sometimes continues for hours. Soon after the accident the 
parts begin to swell in consequence of blood escaping from the 
vessels that are ruptured. 



Immediately after a sprain the joint can be readily moved| 
whereas in a dislocation^ the joint is stiff and rigid in conse- 
quence of the contraction of the muscles. 

When inflammation comes on to repair the injury from the 
sprain, the parts become more swollen and extremely tender, so 
that the slightest motion in the joint will cause pain. 

Treatment. — In sprains the first thing to be attended to, is to 
prevent blood from being effused into the parts from the ruptured 
vessels. This may in a great measure be prevented by pouring a 
stream of cold water upon the part soon after the accident, and 
keeping the part in an elevated position. The stream of cold 
water drives the blood from the parts and contracts the vessels. 
It may be continued fifteen or twenty minutes at a time and re- 
peated two or three times in the course of the first three or four 
hours after the injury. By tliis time the torn vessels will have 
become closed and the parts tlien require to be kept warm and 
bathed frequently with salt and vinegar, No. 6, or stimulating 
liniment. 

When inflammation occurs, evaporating lotions, as alcohol, or 
whiskey, diluted with water, and warm fomentations as worm- 
wood stewed in vinegar must be used. Steaming tbe part occa- 
sionally will prove especially beneficial. If it be the wrist joint 
that is sprained, the arm must be carried in a sling; or if it be the 
ankle joint it should be placed on a chair whilst the patient is 
sitting up, and avoid producing motion in the injured joint. 

Application of Splints, — To secure the joint from motion, 
splints should be applied. This is more particularly necessary 
in injuries of the wrist joint. If motion in the joint be not pre- 
vented whilst the broken tendons, or ligaments are uniting, by 
means of inflammation, it may break up the new adhesions, and 
thus greatly retard the case. It is not until after the inflamma- 
tion has entirely disappeared that motion in the parts should be 
allowed. 

After the inflammation and extreme soreness has subsided, the 
part remaining swollen, the action of the absorbent vessels must 
be promoted by rubbing the parts occasionally with the warns 
hand, or dry flannel, and then applying stimulating liniments op 
embrocations, and bandage the joint as tightly as can be borne 
comfortably, always commencing the bandage at the end of the 
limb. Steaming will also promote the action of the absorbents. 

A joint that has been once badly sprained, will in general re-- 
main weak a considerable length of time, and be more easily 
sprained tlian before. When there is violent pain in the partsj, 
as generally happens immediately after the injury, the patient 
will experience relief by taking a dose of the third preparation of 
lobelia, or a dose of lobelia powder, in composition or pepper tea* 



SECTION Hi. 



BRUISES. 



A slight bruise requires in general but little attention, the in* 
jury being soon repaired. 

A very painful abscess sometimes forms in the heel, in conse- 
quence of a bruise. This kind of abscess is commonly called a 
stone bruise. The proper treatment for a stone bruise when first 
felt is tiie application of steam to the part to promote perspira- 
tion, and keeping the foot on a chair when sitting up. If these 
do not restore the circulation of the part and remove the sore- 
ness, after being repeated two or three times, a warm poultice 
must be applied to keep the parts relaxed and in a perspiration, 
until the abscess points, or there be other evidence of the existence 
of matter in it; the part may be opened, and the poultices contin- 
ued until the abscess ceases to discharge pus freely; after which 
some kind of salve or plaster must be applied to exclude the air 
from the cavity. 



SECTION IT. 



SEVERE BRUISES, BY WHICH THE SYSTEM 
RECEIVES A SEVERE SHOCK. 

In all cases of severe bruises the vital powers of the system 
will be more or less prostrated by the fall or blow^ which occa- 
sions the bruise. A man receives an injury, for instance, a se- 
vere blow upon the head, falls from a height, or is throw^i from 
ahorse wdth such violence as to cause concussion of the brain — he 
will lay senseless and pale; the pulse weak; the breathing fee- 
ble, and in some instances scarcely perceptible. The patient 
may recover his sensibility in the course of a few minutes. If, 
however, reaction sliould not take place, and consciousness in a 
measure be not restored, in a few minutes after a severe injury, 
means should be taken to bring on reaction. These are: rub- 



SEYEUE BRUISES. 343 

bing the surface with the warm hand or warm flanue], keeping 
the head on a level with the body, administering stimulants by 
the mouth and also by injection, and the application of external 
w^armth, either in the form of steam or by the application of warm 
bricks; and bathing the surface and extremities with stimu- 
lants. 

Injections. — Stimulating injections constitute the most efficient 
means of restoring animation in persons that are seriously stun- 
ned by an injury. Two or three teaspoonsfnl of the third pre- 
paration of lobelia should be administered in half a pint of luke- 
warm water; if this medicine be not at hand, almost any stimu- 
lant may be employed, such as capsicum or composition tea, No. 
6, or even vinegar and water or brandy and water. 

Emetics. — The operation of emetics is decidedly beneficial in 
cases of great prostration after severe injuries. If the system 
sustain a severe shock, within an hour or two after the indi- 
vidual has taken a hearty meal, free vomiting will be highly ne- 
cessary. A severe shock to the system, suspends at once the 
power of digestion, and if there be undigested food in the sto- 
mach, it will oppress the powers of life, and may prevent or 
greatly retard the occurrence of reaction. No danger is to be 
apprehended from exciting vomiting under such circumstances, 
namely: where a person is severely injured within an liour or 
two after taking a meal. The best form of an emetic is the third 
preparation of lobelia, given in bayberry tea; or the lobelia 
powder maybe given, adding a portion of No. 6, or capsicum. 
When a person is severely stunned soon after a full meal, ren- 
dering it necessary to produce free vomiting, the usual emetic, 
(lobelia) not being at hand, a tablespoonfiil of ground mustard 
given in warm water, or the patient made to swallow^ warm salt 
water freely, may answer as an emetic. Forcing the feathered 
end of a quill, far down the throat, is sometimes resorted to, in 
order to produce vomiting. 

Animation being restored the use of pure stimulants must be 
continued, in small doses, aided by the application of external 
warmth, with a view to sustain the system, and excite moderate 
perspiration. 

Steaming is of great service to patients wdio have been badly 
bruised. It is always safe to apply the vapour bath, the patient 
being placed on a couch or mattress, w hen he is too feeble to sit 
up. When there is fever, and the patient restless it will not do 
to apply dry heat externally, and even when a moist heat is ap- 
plied during fever it may be necessary to bathe the face and sur- 



S44 SEVERE BRtTISES. 

face of the body with cold whiskey and water or vinegar and 
water. 

External Applications to Injuries — In the case of a bruise, the 
iiesh not being torn or cut, warm fomentations are to be applied 
— a poultice of wormwood stewed in vinegar and thickened with 
rye meal, flannel wet with No. 6, or with salt and vinegar, or 
bathing with stimulants and applying silk oil cloth over the parts 
to favour perspiration. 

When the flesh is both torn and bruised, a poultice must be ap- 
plied, and renewed daily until the parts suppurate and cease to 
discharge matter freely, wlien a simple dressing of salve will 
answ^er a better purpose than a poultice. Whatever emollient 
substance the poultice be made of, a portion of ginger must be 
added to render it moderately stimulating. 

Bruises on the head, may be treated by the application of No. 
6, or salt and vinegar. If the scalp should be cut, the edges of 
the wound must be properly adjusted, the hair cut away, and 
strips of adhesive plaster applied across the wound leaving space 
for the escape of the blood and serum that oozes from wounds in 
general; soft lint must he laid over the wound, and a bandage or 
cap applied. If the patient complain of great heat in the part, 
the head may be w^et occasionally with whiskey, vinegar, or with 
No. 6. The application of No. 6 to a wound, is useful, as it 
stimulates the vessels and aids them to carry on healthy inflam- 
mation, by which the wound is healed, or the injury repaired. — 
A severe injury never was healed nor injured parts restored to a 
healthy condition without the aid of inflammation. Therefore in 
severe injuries tlie indications are not to subdue inflammation, but 
to aid and regulate the healing efforts of nature, by sustaining an 
equilibrium in the circulation, promoting the secretions both of 
the skin and internal organs, regulating the temperature of the 
inflamed part, and supplying the stomach with food suited to its 
condition. If two individuals one in vigorous health and the 
other feeble and with but little constitutional vigor, should both 
receive a severe wound of equal extent; in the healthy person the 
inflammation in the part will be of a healthy character and run 
its course quickly; whereas in the other the efforts of nature 
being feeble and the blood not so richly supplied with nourish- 
ment, the inflammation will be more liable to assume an un- 
healthy character or the wound be tedious in healing. And 
again when a patient is in bad health, the system does not possess 
the same power to maintain an equal circulation of blood through- 
out the system as when in health, and therefore congestion or an 
undue accumulation of blood in injured parts will be more likely 
to occur. 



SEVERE BRUISES. 345 

When tliere is mi undue determination of blood to arj injured 
part, occasioning much swelling and hardness, attended with a 
sense of great heat and pain, the parts should be kept wet with 
evaporating lotions, as camphor and water, alcoliol and water, or 
vinegar and water; the patient should be taken through a course 
of medicine, if the severity of the symptoms demand it, together 
with the continued use of stimulants and broken doses of lobelia, 
with a view to promote perspiration, and excite the secretions of 
the stomach and bowels aided by the application of external 
warmth. 

Severe injuries are in general followed by more or less fever, 
in the course of a few days after the injury: the tongue will be- 
come dry and furred, the skin hot and dry, and the pulse in- 
crease in hardness and quickness. In this condition of the sys- 
tem stimulants — capsicum, ginger, composition or simple herb 
teas must be given, together with small doses of lobelia, bathing 
the surface when needed, with alcohol and water, or vinegar and 
water, and occasionally the administration of a vapour bath, fol- 
lowed by an emetic, if the system be much disordered, or the in- 
jury assume an inflammable appearance. 

Case, — -A young man engaged in a manufactory, had his arm 
caught between two large cog-wheels, which tore the flesh from 
one half of the arm from a few inches above the elbow up to the 
shoulder, and split off a portion of the arm bone which caught in 
between the cogs, and stopped the machinery. The shoulder 
and part of the back were bruised into a jelly. The physicians 
of the village were called, who decided that the arm must b« 
taken off at the shoulder, and appointed the hour for performing 
the operation. The patient, however, requested that his step- 
father a Thomsonian physician who resided some miles distant, 
should be sent for. On his arrival he applied a poultice over the 
whole of the injured parts, carried him through a course of medi- 
cine; occasionally repeated it, and gave freely of stimulants 
to promote the curative action of the system, and in six weeks 
the wounds were perfectly healed. If tlie great vessels and veins 
of the arm had been broken off, no treatment could have saved 
the patient's arm; but when these are not destroyed, however 
severe the injury may be, there is a probability of saving the 
limb. 

Case. — Mr. R — was thrown violently upon the pavement by 
the overturning of a suikey, which left him for sometime senseless 
and bruised him internally, so that breathing was painful, and 
he raised small quantities of blood. After his sensibility was re- 
stored and he conveyed home, two piiysicians tliat had seen 
him shortly after the injury, called to ascertain how he was, and 

2 S 



346 W GUILDS OF THE SCALP. 

on being apprised of the fact that Mr. R. was a Thomsoniati^ 
they requested to know what medicine he was taking; and when, 
some composition tea was handed them and they were informed 
that this was the medicine the patient was taking, they manifested 
great surprise and gave it as their judgment that such medicine 
would throw the patient into a fever and endanger his life. Mr. 
R. however took freely of hot medicine, was steamed every 
day, was taken through one course of medicine, and recovered 
rapidly without the occurrence of a bad symptom. Physicians 
employ bleeding and purging to prevent inflammation, and al- 
though they may relieve pain at the time, yet it enfeebles the 
curative efforts of nature, increasing the liability to unhealthy 
inflammation, and doubtless in many instances <lestroys the life of 
the patient. The practice of bleeding in injuries is so generally 
adopted by physicians of the old school, that it is thought by the 
community to be necessary, and when a person receives a severe 
injury every one is recommending bleeding as the first and most 
important rem&dy, so that sometimes it requires no small amount 
i)f courage to withstand this popular mania for bleeding. 



SECTIO^f V. 



WOUNDS OF THE SCALP. 

Wounds of the scalp, more especially when the parts are 
bruised and lacerated require strict attention, such wounds 
being often observed to be followed by serious consequences. A 
simple cut through the scalp with a sharp instrument, heals in 
general, without difficulty, except in persons of depraved habits, 
or in bad health from other causes. Wou^nds of the scalp are 
particularly liable to produce erysipelas, which sometimes 
affects the brain so as to endanger life. 

Treatment, — In severe injuries of the head, the edges of the 
wound must be properly adjusted, the hair shaved off closely 
around the edges of the wound, the parts washed with whiskey 
and water, or with warm water, lint laid on the wound, and a 
bandage applied. In bandaging the head especial care must be 
observed to have the hair combed smooth into its natural posi- 
tion, for if a lock of hair be turned the wrong way and bound 
down, it will occasion soreness of the scalp. Wounds of the scalp 
must never be stitched. 



WOUl^'DS or THE SCALP. 34f 

The Dressing not to he Removed too soon. — In Wounds not on'y 
©f the scalp, but of every other part, the dressing should not le 
removed so as to expose the wound to the air until the fourth, op 
fifth, or even the eighth or ninth day after the occurrence of the 
injury. If the injured part become painful and very hot, the 
head must be dampened with whiskey or vinegar, and be kept 
elevated. Wetting the parts around the injury with No. 6 oc- 
casionally, and even permitting it to come to the wound will les- 
sen the tendency to erysipelas, or unhealthy inflammation. Ad- 
hesive inflammation is necessary — injuries cannot be repaired 
without it, and I know of no local application superior to the No. 
6, to stimulate the vessels and assist them to establish adhesive 
inflammation. 

Constitutional treatment should always he employed in wounds 
of the scalp. Soon after the wound is inflicted, the patient should 
be carried through a course of medicine, more especially if the 
wound be severe, and repeated as often as the condition of the 
system may require it. If the bowels be costive, they must be 
evacuated by the use of the syringe. 

Perspiration, — It is important to promote the secretions and 
exhalations of the skin by the use of stimulants that neither dis- 
order the brain, nor aggravate inflammation. Capsicum, com- 
position, or ginger tea may be used freely and with safety. Sim- 
ple herb teas may be employed for the same purpose. The feet 
must be kept warm. When a patient is feverish, a small portion 
of lobelia should be added to the stimulants given, and the sur- 
face bathed occasionally with some alcoholic preparation. 

Should symptoms occur denoting inflammation of the brain— « 
pain in the head, flushed countenance, intolerance of light and 
sound, and delirium, the system must be placed under the influ- 
ence of lobelia, taken in the usual way, and also administered by 
injection. A tablespoonful of brown or green lobelia may bo 
administered by injection at a time, prepared in luke-warm wa- 
ter, and retained; and occasionally a stimulating one also may 
be administered — or a tablespoonful of the third preparation of 
lobelia in bayberry tea. I have frequently given the third pre- 
paration of lobelia to patients labouring undei* symptoms of in- 
flammation of the brain in low forms of fever, and have invaria- 
bly observed good effects to result from it; in many instances 
after vomiting, the delerium has very materially moderated, and 
in some instances disappeared for a time. 

In inflammtition of the brain from injury of the scalp, it will 
be proper to relax the system by the lobelia enemas, and the ap- 
plication of vapour to the body before giving an emetic of the 
third preparation of lobelia. This treatment must be |)ermanent- 



348 WOUNDS OF THE SCALP. 

ly employed, for inflammation of the brain often proves fatal un- 
der any mode of treatment. The hair must be cut short and 
the head raised upon pillows, and cloths applied wet with alco- 
hol or vinegar, or if there be erysipelatous inflammation of the 
scalp, No. 6, or the third preparation of lobelia must be used on 
the inflamed part, whilst on other parts of the head the first men- 
tioned articles may be used. 

When there is evidence of matter under the scalp, an opening 
should be made with a lancet, to allow the pus to escape; after 
which especial care must be observed to shield the parts from 
the air by a stimulating poultice or plaster spread upon oiled 
silk, and if a poultice be employed it must be kept moist with 
w^arm water containing about one-fourth of its quantity of No. 
6. Equal quantities of composition powder and slippery elm, 
mixed with lard, form a suitable poultice in erysipelas, attended 
with the formation of matter in the parts. 

The practice advocated by some physicians and denounced by 
others, of prescribing bark and wine to patients labouring un- 
der erysipelas of the scalp^ when the secretions are in a great 
measure suspended, is not much less objectionable than the ab- 
surd practice of bleeding patients ^^ almost to death,'' in inflam- 
mation of the brain. In the earlier stages of erysipelas the me- 
dicine employed should be such as excite the secretions both of 
the skin and of the mucous membrane of the stomach and bow- 
els. Hence when the tongue is dry, as a general plan of treat- 
ment, use pepper tea, either alone or combined with simple herb 
tea, such as pennyroyal, balm, &c. and broken doses of lobelia, 
and apply a moist heat to the surface of the body and feet. A 
case of erysipelas that would be aggravated by the use of bark 
and wine, would be relieved and benefitted by the treatment as 
above described. In any case of fever in which the secretions are 
suspended, bark and wine would prove more or less deleterious, 
whereas the treatment above mentioned would relieve the symp- 
toms and assist nature to gain the ascendency over disease. 

Inflammation of the brain is always attended with danger, and 
therefore in injuries of the scalp, or concussion of the brain, 
treatment should be early applied to cleanse the stomach, pro- 
mote the secretions, and sustain the equilibrium of the circula- 
tion, as the surest means of preventing inflammation of the brain. 
Even slight injuries of the scalp should not be neglected, as very 
small wounds of the head, have frequently been observed to oc- 
casion dangerous symptoms through neglect or exposure. — 
Wherever the scalp is the least torn or cut, it must be protected 
from the air, otherwise erysipelatous inflammation may be the 
consequence. 

Case, — Wm. Be Smith received a severe blow upon the side of 



WOUFDS or THB SCAIP. 349 

the head from some machinery in an iron foundry, which left 
him senseless a considerable length of time; the scalp was cut to 
the bone, the wound being about two inches in length and lacerat- 
ed at the edges. This wound was dressed with strips of adhesive 
plaster (the hair having been previously shaven from the edges 
of the sore) dry lint applied and the head carefully bandaged. — 
This patient was placed under a course of Thomsonian treatment, 
the vapour bath administered every day, and means used for pro- 
moting perspiration, and also other secretions, such as com- 
jjosition or pepper tea, and warm bricks to the feet; and the 
bowels regulated by the use of enemas. On removing tlve dress- 
ing from the head, on the seventh or eighth day I found the 
wound healed, by ^^ first intention^' as it is termed, a circum- 
stance rarely occurring in wounds of this kind. A physician 
residing near the place where this accident happened was sent 
for immediately after the accident, who observed to some of the 
patient's friends, that if he (the patient) was not bled, his life 
would be endangered. The patient however, was neither bled, 
nor purged; and although the shock was very severe he recovered 
without the occurrence of an unfavourable symptom. 

Diet. — In all cases of severe injuries the diet should be light. 
Gum arable mucilage, elm gruel, milk porridge, toast and tea, 
custard, and oat meal and Indian gruel form suitable articles of 
diet when the digestive powers are in a prostrated condition. In 
a later period when the injured parts are secreting matter 
freely, or the patient is free from any considerable degree of 
fever the tongue moist and the patient is disposed to perspiration, 
then a more nourishing diet will be required, as chicken soup, 
beef steak, mutton, eggs, stale wheat bread, &c. 

Tonics. — When an injured part or an abscess discharges mat- 
ter freely and the system is in a relaxed condition, bitters must 
be taken to strengthen digestion. 



SECTIOJiT Yt, 



WOUNDS PRODUCED BY SHARP INSTRUMEKTS.^ 

SiMPXE cuts made by sluirp instruments heal more readily 
tlian any other kind of wound of the same extent. 

In treating a simple wound, the first thing to attend to is to 
arrest the bleeding. If an artery be cut the blood will be of a 
bright red colour, and come in jets; dark blood comes from veins. 
When a bloodvessel is cut or torn, a gluey substance is secreted 
by the coats of the injured vessel which gradually plugs it up 
and entirely stops the escape of blood. Arteries the size of a 
crow quill though they may bleed rapidly at iirst, will soon be- 
come plugged up by this admirable processs of nature. 

An intelligent person once related to me the following circum- 
stance to prove that some persons possessed the power of stopping 
the flow of blood without seeing the patient. A young man who 
was cut badly continued to bleed profusely until the family be- 
came alarmed, and sent a messenger off post haste to a dutch- 
man, who lived twenty miles distant, who it was thought pos- 
vsessed the power to stop bleeding. On the messenger arriving 
at the residence of the dutch doctor, and made known his mis- 
sion, he was asked the name and age of the patient, on being in- 
formed in these particulars, he told the messenger to go home 
now, that the bleeding w ould be stopped before he got back; and 
sure enough the bleeding had ceased, because nature had been all 
this time filling up the vessels until they had finally become 
closed. The dutchman however received the credit of stopping 
the blood and of saving the young man's life. 

Pressure, — Unless when a large artery be cut the bleeding may 
be arrested in a short time by pressing upon the parts with a 
sponge or a compress of folded linen or muslin. 

Fosition. — Bleeding from a cut upon the extremity of a limb 
may be partly arrested by holding the limb above the level of 
of the body; aided by pressure upon the part. 

Dr. Bellvil who was a Yery eccentric, but most distinguished 
physician, of Trenton, N. J., was sent for in great haste to as- 
sist another doctor to take up an artery that was bleeding. The 
messenger informed the Dr. that the cut w^as in the ball of 
the thumb and that the doctor w'ho was there had been searching 
two hours for the arterv without beina: able to find it. The doc- 



WOU!*rDS PRODUCED BY SHARP INSTRUMEJiTTS. 351 

tor was surprised that a physician should be probing the parts 
and keep the blood running by searching for an artery in a part 
where the vessel would soon stop bleeding if bound up and left 
alone, refused to attend the summons, and told the messenger to 

go home and bind up the wound, and cut the d- d doctor's 

head off. 

Cleansing the Parts. — After the bleeding is stopped, or so 
nearly so as to admit of the wound being dressed, the pai'ts 
should be cleared of all extraneous substances and the clotted 
blood removed from the surface and edges of the wound. 

Placing the injured parts in their proper position is the next step 
and this is of some importance. In a simple straight incision 
there is seldom any difficulty in keeping the sides of the wound in 
a proper position, unless when the wound is extensive and cut 
across a muscle, — for when a muscle is cut across the contraction 
of the muscular fibres will separate the sides of the wound and 
break up the new adhesions as they are formed by the healing 
process. 

When a portion of flesh is badly cut stitches may be required; 
the stitches should be made wdth a fine sewing needle, threaded 
with cotton or silk, and should not penetrate beneath the skin. 

Adhesive Plaster. — Never cover the whole of a w^ound with ad- 
hesive plaster, but put it on in strips leaving sufficient inter- 
spaces to allow the escape of blood and serum from the wound. 
Lint is to be applied over the strips and the part properly bound 
up. 

Bandaging the Limb. — In cases where muscles are cut across, 
for instance, a deep cut across the calf of the leg, or across the 
thigh, or the fleshy part of the arm, the limb should be bandaged 
from its extremity up to the next joint above the injury. Thus 
if on the calf of the leg the limb should be properly bandaged up 
to the knee and kept in a flexed position, and all motion of the 
limb avoided until complete union has taken place. 

Evaporating Lotions. — When a wound becomes hot and pain- 
ful, evaporating lotions, alcohol, or camphor and water must be 
applied, or the parts kept wet with cold water; still the dressing 
must not be removed, except so far as to loosen it, if it becomes 
too tight. A bandage should always be wet before it is applied, 
otherwise it will shrink and become too tight; in which case it 
becomes necessary to wet it after it is applied. 

In large wounds stitches are generally preferable to adhesive 
plaster, for the parts require th^ application of evaporating lo- 



35^ IiACERATED WOUNDS. 

tions, which will rentier adhesive plaster of little use. Where^ 
however, the sides of the wound can be kept in perfect apposition 
by bandaging, both the adhesive plaster and stitches may be dis- 
pensed with. 

Removing the dressing too soon may very materially retard 
the cure; this should therefore be avoided until several days or 
even a week has elapsed after the occurrence of the injury, un- 
less it becomes painful or offensive from the putrefaction of the 
blood and secretions confined under the dressing. 

Constitutional Treatment. — A simple cut seldom requires con- 
stitutional treatment; still slight wounds are sometimes observed 
to become converted into very troublesome sores through neg- 
lect, and exposure to cold and dampness. In large cuts consti- 
tutional treatment will be necessary when the patient is in bad 
health, or the wound becomes very painful or assumes an un- 
healthy appearance. The constitutional treatment indicated 
w ill not differ from that already recommended in injuries of the 
scalp. A single course of medicine will sometimes cause a 
wound that presents an unhealthy appearance to become greatly 
improved in its general aspect in the course of a few hours. 



SECTION VII. 



LACERATED WOUNDS. 

Lacerated wounds are made by rough instruments which 
tear the fibres of the flesh. 

Lacerated Vvounds rarely bleed to any considerable extent; 
even large arteries may be torn asunder without occasioning 
much loss of blood. 

Lacerated wounds are more difficult to heal than a smooth cut, 
they seldom unite without the formation of pus. They are also 
much more liable to be attended with unhealthy inflammation, 
and constitutional disorder, than wounds made by a sharp and 
smooth edged instrument. 

The Treatment, both local and constitutional, is the same as 
described for wounds produced by sharp instruments, except that 
lacerated wounds demand more attention both in relation to 
evaporating lotions to the parts, and constitutional treatment. 



SECTION VIII. 



BRUISED WOUNDS. 



These are wounds in which portions of flesh are torn, mashed 
or bruised so as to destroy the vitality of the injured parts. 

Treatment — Warm fomentations and moderately stimulating 
poultices are required in order to favour suppuration — the method 
employed by nature to remove the disorganized flesh. When 
the dead parts have sloughed away, the poulticing is to be aban- 
doned; the sides of the wound drawn together, by strips of ad- 
hesive plaster, and the air excluded from the wound by salve 
spread upon soft linen or muslin and applied over the parts, and 
then properly bandaged. If the parts continue to form matter 
freely, lint should be applied to absorb the pus. The dregs of 
No. 6, mixed with about an equal quantity of elm form a good 
poultice. 

The Constitutional Treatment should be regulated to suit the 
exigencies of the case. Promote the secretions by the use of pure 
stimulants; if the system be much disordered administer a course 
of medicine; and during the process of suppuration give tonics. 

Tlie Diet should be nourishing provided the patient be clear of 
fever and the tongue clean, or cleaning. 



SECTION IX. 



PUNCTURED WOUNDS. 



Wounds made by pointed instruments, dirks, hooks, scissors, 
nails, &c., are much more liable to be followed by serious conse- 
quences than cuts made by^ sharp edged instruments. 

Punctured wounds in tendonous parts, as the palm of the hand 
and ball of the foot are far more dangerous than when they hap- 
pen in fleshy parts, devoid of tendons. 

Punctured wounds in the palm of the hand or in the bottom 

2T 



S54 rUHCTUHED WOUNDS 

of the foot are apt to close up without the occurrence of adhesive 
inflamniation or the discharge of matter. Such wounds are fol- 
lowed frequently hy much constitutional disorder, and sometimes 
by locked jaw. When matter is formed at the bottom of a punc- 
tured wound in tlie palm of the hand, sole of the foot, or in other 
tendonous parts, as about large joints, it may be confined and be 
prevented from passing off by the firm and dense tissues about 
these parts, and require an opening to be made by a lancet to 
allow the matter to escape. 

Treatment- — In punctured wounds means shfwld be employed 
to excite adhesive inflammation, by pouring in the wound No. 6, 
or spirits of turpentine, and then apply a stimulating poultice to 
the part. The poultice should contain a considerable portion of 
cayenne pepper, so as to attract blood to the part and establish 
adhesive inflammation and suppuration. It is the deficiency of 
blood in tendonous parts, as in the palm of the hand and sole of 
the foot, that occasions punctured wounds in these parts to close 
without the occurrence of inflammation, or the formation of pus. 

If the hand or foot be pierced by a rusty nail, the w^ound 
should be cleaned out by a probe, or syringe with soap suds, op 
simple warm water, and then pour into the wound No. 6, 
or spirits of turpentine, and apply the stimulating poultice. 

If the stimulating poultice after continuing on several hours, 
should become extremely painful, causing an unnecessary afilux 
of blood to the parts, it may be removed and one less stimulating 
applied, which must be kept warm, and the limb elevated by a 
sling, if on the hand; or if the wound be on the foot, it should be 
raised on a chair when the patient is sitting up. 

Constitutional Treatment is highly necessary in cases of severe 
punctured wounds, more esi^eciaOy if the wound be about a large 
joint, or in the palm of the hand, or ball of the foot. A course 
of medicine should be first given, after which the patient should 
take sufficient of composition, pepper tea, spice bitters, or other 
stimulants to promote a healthy action throughout the system. 
In proportion as tlie vital power is strong, in the same propor- 
tion will the constitution be able to resist the influence of dis- 
ease. A man whose stomach is in a healthy condition, and 
w4iose digestion is good, will be much less liable to haveliis sys- 
tem seriously disordered by a local injury, than one whose sto- 
mach is foul, and his digestion imperfect. 

Exposure to cold and dampness and excesses of every kind 
should be avoided by those who .have received a punctured 
wound. 



SBCTION X. 



WOUNDS OF JOINTS. 



A wound of a large joint, for instance, of the knee where the 
cavity of the joint is ci^t into so as to allow of the escape of the 
joint-water is an accident of the most serious character. When 
such a wound occurs in an aged person, or in one of an un- 
healthy constitution the patient very rarely recovers the use of 
the joint and it not unfrequently terminates fatally. Young 
persons of vigorous constitutions may in general recover iVom 
such injuries, still there is great danger attending wounds of the 
large joints. 

Treatment. — In wounds of a joint the first and by far the most 
important point in tliQ treatment is the closing of the wound im- 
mediately, in order to exclude the air from the cavity of the 
joint. Dry dressing must be put on and as soon as the parts 
are well secured from tlie air the limb must be bandaged com- 
mencing at the foot and carrying it up to the knee; the wound 
should be covered with lint, and the knee well bandaged. The 
object of applying a dry dressing is to favour the healing of the 
parts without the formation of matter, and of excluding the air 
from the joint. A poultice must never be applied where joints 
are cut into, until after the lapse of several days, and the parts 
exhibit marks of suppuration, or the formation of matter — then 
it will be proper to apply a poultice. 

"When the joint is dressed a splint must be applied to the under 
side of the limb in order to prevent the possibility of motion in 
the parts; for if motion be allowed in the joint, the new adhe- 
sions will be broken up, and a union by the first intention there- 
by prevented. As the parts swell the dressing must be loo- 
sened. 

After the wound is dressed, the dressing immediately over the 
wound must be kept wet with No. 6 or the tincture of lobelia, 
as a means of exciting adhesive inflammation. After this has 
been applied a few hours, if the joint become very hot and pain- 
ful, the dressing may be kept damp with alcohol or vinegar. 

Constitutional treatment must be early applied unless the sys- 
tem be comparatively clear of disorder. Injuries of large joints, 
however, are necessarily attended with much constitutional dis- 
order, and more especially if the wound does not heal without 



556 BURN'S AND SCALDS. 

suppuration occiUTing, The bowels are to be regulated by the 
use of injections; the secretions promoted by giving stimulants' 
such as capsicum, composition, or simple herb teas; and when 
there is fever, give small doses of lobelia in combination with 
the stimulants. In aggravated cases there is no means upon 
which so much reliance can be placed as upon full courses of 
medicine and the free use of the third preparation of lobelia. 

The diet must be light at first, avoiding every thing that is 
unwholesome, or hard of digestion* In the more advanced 
stages of the injury the diet must be nourishing, provided the 
stomach can digest it. 

If the wound suppurate tonics must be given unless the tongue 
be dry and the patient feverish, and even under these circum- 
stances the spice bitters may be used. Wounds of the large 
joints require great exertion on the part of the constitution, to 
repair the injury, creating the necessity for all the support that 
can be afforded by stimulants, tonics and nourishing food. 



'SECTION- X. 



BURNS AND SCALDS. 



For slight burns or scalds in which the skin is not^destroyed^ 
the best application is cold water, either holding the part in a 
basin of cold water or apply cloths on the parts, kept w et with 
cold water or whiskey and water. This is to be continued until 
the smarting ceases; then cover the parts with an ointment pre- 
pared of sweet oil and lime water, or bind dry cotton on, or 
cover the parts with oiled silk. When blisters are formed avoid 
breaking the skin until the parts have had time to secrete a layer 
of lymph on the surface of the burn, which will protect the parts 
from the action of the air. The best way to open a blister is to 
pierce it in several places with a needle, and then cover the 
parts with a thick layer of carded cotton, or soft muslin cloths 
kept damp with alcohol and water, or whiskey and water, and 
this continued until the parts cease to be painful; or apply some 
simple ointment; the one above mentioned is to be preferred. 

Avoid removing the dressing nntil several hours or even a day 
or more has elapsed. Removing the dressing too soon breaks 
up the tender skin that nature forms, aggravates the burn, and 



BUftNS AND SCAIDS. 357 

greatly retards the cure. "Whatever dressing he applied to a 
Burn, which is found to relieve the pain, whether it be dry cot- 
ton, cloths wet with evaporating lotions, sweet oil and lime wa- 
ter, or a poultice of scraped potatoe or carrots, it should be al- 
lowed to remain on, at least for several hours, or even much 
longer, unless there be a necessity for its being removed. 

When the outer skin is removed at the time of a burn or scald, 
I mean the skin that raises up where a blister is formed, the 
parts should be covered as speedily as possible, with an ointment 
of lime water and oil, lime water and milk, or of lard and com- 
mon soot from the chimney well rubbed together. Whilst the 
ointment is preparing, the part may be held in cold water or 
wet cloths laid on to relieve the pain. The ointment must be 
spread on linen or muslin, and when applied, cloths or cotton 
may be laid on this dressing, kept damp or wet with cold wa- 
ter, to relieve the pain. The under dressing must not be re- 
moved for two or three days; indeed it is better to let the first 
dressing remain on until a new skin be formed on the burned 
parts. 

When a part is seared so as to destroy the skin, from live 
coals or a red hot iron, sl poultice must be applied; for when the 
under layer or true skin is disorganized, suppuration will take 
place and instead of a new skin being formed as there will be 
when only the outer layer of the skin is removed, the parts will 
heal by drawing together, and thus form a scar or seam in the 
skin. The poultice recommended by Dr. Thomson which 
consists of a compound of slippery elm, white pond lily root, 
cracker, and a small portion of ginger, all finely pulverized and 
wet with a strong tea made of raspberry leaves, form as good a 
preparation probably as can be devised. The poultice will re- 
quire to be wet occasionally, and when the parts are suppurat- 
ing freely a fresh one must be applied daily, until the suppura- 
tion is completed, when a salve must be employed to shield the 
parts from the air, until they are healed. When granulations 
shoot up, forming what is termed proud flesh, they should be 
covered with burned allum, or finely powdered marsh rosemary 
before the salve be put on. 

Where parts are scalded under clothes, and the clothing can- 
not be removed without breaking or removing the skin, it should 
remain on, keeping the parts wet with alcohol and water, or 
with simple cold water, and not removed for several hours unless 
the clothing prove a source of irritation to the parts. After the 
pain subsides through the continued application of evaporating 
lotions, the clothing over the burn may be saturated with some 
one of the ointments above mentioned, in order to exclude the 
air. 



^58 BURNS AND SCAEDS. 

Constitutional Treatment— Severe burns or scalds generally 
occasion great prostration of the powers of life, manifested by 
chilliness, coldness of the surface, extreme prostration of strength, 
a weak pulse, and sometimes stupor or delirium. Under these 
circumstances stimulants and emetics must be given. If an in- 
dividual receive a severe burn or scald soon after taking a hear- 
ty meal, the food will not be digested, and if not thrown off by 
vomiting, it will oppress the vital powers. It is always safe, 
and generally highly necessary to give an emetic after a severe 
burn or scald. The best form of emetic for all cases where the 
vital powers are prostrated, is the liquid of the third preparation 
of lobelia, or the lobelia powder, steeped in strong composition 
or bay berry tea, adding a portion of cayenne pepper, or No. 6. 

Stimulants.— Stimulants, such as here recommended, given 
internally, will not aggravate a burn or scald on the surface. 
By giving stimulants we aid the constitution in maintaining the 
natural equilibrium of nervous power between the great centres 
of the system and the surface of the body, which is an important 
indication in the treatment of all forms of disease, whether ge- 
neral or local. The stimulants to be employed are capsicum, 
composition, or ginger tea. These stimulants may be given at 
all times; and when there is fever, broken doses of lobelia should 
be added to them, or taken separately; and if the skin be very 
liot and dry, bathe it with vinegar and water or spirits and wa- 
ter, to reduce its temperature down to the sweating point. 

Vapour BatJi.'--T\iere is no objection to the use of the vapour 
bath in cases of scalds and burns, the parts being kept covered 
by the dressing during the steaming. Wlien the patient remains 
in a torpid or sunken condition, or the burn or scald becomes 
very painful after the lapse of a day or two, or at any sabsequent 
period after the first pain from the injury has subsided, the va- 
pour bath will prove especially beneficial, not only in relieving 
the pain in the parts, but it will aid the healing efforts of the con- 
stitution. I recently attended an old lady who had her foot bad- 
ly scalded, and not being treated properly in the first place— the 
dressing being frequently removed, the lymph which was thrown 
out by the raw surface, designed to form a new skin, was taken 
off by the frequent changing of the dressings, and the scalded 
surface assumed an unhealthy appearance, the foot was extreme- 
ly painful, which continued for weeks with but little intermission, 
except when the parts were wrapt in wet cloths and cold water 
applied. All the applications that were made to the foot failed 
of exciting the healing power, or to make any favourable change 
in the part until the vapour bath was resorted to; the foot was 
steamed from an half to three quarters of an hour at a tsme wit!]- 



BLKNS AND SCALDS. 359 

out any dressing on, and this repeated daily until a new skin was 
formed over the loot. This patient experienced more benefit 
from a general steaming than when it was merely applied to the 
foot. 

To Prevent Beformity. — Great deformities are apt to take 
place after severe burns, when the true skin is destroyed. If, 
for instance, the palm of the hand and between the fingers be 
badly burned, the natural tendency in the parts will be to con- 
tract: the hand to be clenclied and the fingers to unite together. 
This is to be prevented by binding a splint on the back of the 
hand, the splint being sawed at the extremity, so as to furnish a 
separate splint for each finger. The parts must be first dressed 
and then the splint applied. Especial care must be observed to 
interpose dressing between the fingers to prevent their uniting 
together. I once witnessed a very painful and bloody operation 
on a man wiiose arm had grown fast to his side in consequence 
of a severe burn, the proper care not having been taken to pre- 
vent the burned surfaces from coming together when healing. 
Severe burns on the neck are almost necessarily followed by more 
or less delbrmity. I have seen several cases wliere the chin was 
drawn down to the collar bone, the patients being unable to raise 
the chin from the breast. A severe burn on the inside of the arm 
at the elbow would naturally tend to bond the arm when healing; 
and if allowed to heal in this position the patient will ever after 
be unable to straighten the arm. This deformity is to be pre- 
vented by applying a splint to the back of the arm, so as to 
keep the limb straight. 

I have heard Dr. George M'Clellan relate a case of a child 
that w^as severely scalded over the greater part of its body, and 
the mother in her fright, wrapped the child in carded cotton, a 
heap of which happened to be in the room at the time, which soon 
relieved the pain so that the child dropped asleep, and when the 
cotton was removed, the skin was not blistered. The doctor re- 
lates another instance of a boy who was severely scalded by fall- 
ing into a soap boilers kettle, when some one in the establish- 
ment spread out a blanket, covered it over with soap-fat and soot 
well rubbed together, laid the boy on the blanket and then 
wrapped him in it. This dressing was not removed until a new 
skin was formed over the scalded parts, and the patient was soon 
well. 



SECTION XI. 



CHILBLAINS. 



Chilblains are most liable to occur on the heel, the toes, and 
sides of the foot. The parts affected are somewhat swollen, red, 
and at particular seasons of the year, or on w'arming the feet by 
the fire they itch very much and are painful. 

Causes, — -Chilblains are produced by severe coldness in apart 
being too suddenly warmed by the fire. 

Preventive measures. — When the feet or hands are benumbed 
by cold, and great pain is occasioned as they begin to warm, they 
should be placed in cold water and kept there until the parts 
cease to be painful, when they are removed from the cold water; 
or the parts may be bathed or rubbed with alcohol, whiskey, 
opodildock, or spirits of camphor, and kept away from the fire, 
or from a warm room as long as there is pain experienced. 

Treatment — Chilblains, unless properly treated, may continue 
to be occasionally swollen and prove a source of great annoy- 
ance for years, unless proper means be taken to overcome the de- 
bility of the vessels of the parts. A very good plan of treating 
chilblains is to bind on the parts a poultice composed of wheat 
bran, soft soap, and fine salt; the poultice to be continued on an 
hour or two at a time, and then the parts to be bound up with 
oiled silk and not allowed to be near the fire. The oiled silk to 
remain on several days* Another plan of treatment is to rub 
the parts with oil of turpentine, and then rub on stimulating 
ointment on a piece of bladder or silk oil cloth, and bind it on the 
parts. This application to be repeated every night until th© 
parts are restored to their natural condition. 



SECTION XII. 



TREATMENT OF FROZEN LIMBS. 

When a part is benumbed or frozen, the most important indi- 
cation in the treatment is to regulate the temperature around the 
frozen part, carefully guarding against warmth until the ves- 
sels recover sufficient strength to carry on the circulation. A 
frozen part should never be thawed by the application of exter- 
nal warmth, or it will be followed by violent inflammation if not 
by mortification. It would seem that the application of warmth 
to a frozen part, destroys the natural equilibrium of nervous 
energy between the great centres of the system and the surface 
of the body. In such cases the blood which is attracted to 
the surface by the warmth, is not circulated or returned 
back as it should be, a tendency to putrefaction or disorganiza- 
tion occurs, attended with violent inflammation, followed per- 
haps by mortification. 

A part that is frozen must be kept in cold water, even adding 
snow or ice to it, and this continued until the parts are complete- 
ly thawed, and then the temperature around the part should be 
increased vei^y gradually^ not allowing a sudden change from 
cold to warmth. Covering the frozen parts with snow is a good 
practice. 

If a person besides "having his limbs frozen should be greatly 
benumbed and chilled throughout the body — nearly frozen to 
deatli — he should not be taken into a warm room, but be laid in 
a room without fire. It would be even better that the patient 
remain in a barn than to be placed in a temperature much above 
that of the external air. I have heard a case related of a man 
frozen severely and stifl*, who was restored by being placed in a 
cask of pickled cabbage, commonly called sour-crout. 

Stimulants must be given to support the living powers. — 
Cayenne pepper, composition, ginger tea, carbonate of ammonia, 
w^arm brandy toddy, and No. 6 in warm water may be employed 
as stimulants; and wine whey, essence of beef or chicken tea may 
be given as nourishment, until the powers of digestion are in- 
creased so that other kinds of food can be digested. Stimulating 
injections will aid in restoring animation. 

When a part of a limb is frozen without the body being very 
much benumbed with cold, the patient may remain in a comfort- 
ably warm room, observing the precaution to keep the frozen part 

2 U 



362 "TSEAf MENT OF FROZEN XlMBS. 

in cold water, or enveloped in snow, until it be thawed; and then 
the parts may be wrapt in cloths kept damp with whiskey, alco- 
hol, spirits of camphor, or vinegar. A most important indica- 
tion in the treatment of frozen parts is to **keep down the out- 
ward heat" of the injured parts, or a stagnation of the blood in 
the parts will be the consequence. When through improper ma- 
nagement in the first place or from other causes, a part that has 
been frozen becomes inflamed, threatening mortification, a poul- 
tice must be applied, composed of elm, white pond lily, cracker 
and ginger; the poultice to be kept wet with cold water, and 
the limb elevated. The yeast poultice mentioned in the materia 
medica may be employed. The patient should also be placed 
under active constitutional treatment, in order to aid the efibrts 
of nature. A full course of medicine should be administered and 
frequently repeated in all cases where mortification is threaten- 
ed, and stimulants given freely to excite the secretions, and in- 
crease the power of action in the enfeebled vessels, thus lessening 
the tendency to conjestion of blood in the parts. It is common 
in the old practice to prescribe bark and wine in cases of morti- 
fication; such remedies, however, when the secretions are sus- 
pended, the tongue being dry and the skin dry and harsh, w411 
necessarily prove injurious. But if a patient in the condition 
above described, be carried through a course of medicine, and 
followed by a free use of cayenne or composition tea, adding 
small doses of lobelia, the symptoms will generally assume a 
more favourable aspect, and certainly never be aggravated by it. 

Tomes.— There is a condition of the system when barks and 
wine will prove of great benefit in cases of mortification, or in 
cases of recovery from the effects of freezing. When the tongue 
is cleaning, and moist, and the surface of the body inclined to mois- 
ture, tonics may be given freely. Peruvian bark, quassia, co- 
lumbo root, Virginia snake root, balmony, golden seal, quinine, 
poplar bark, or spice bitters, may be employed either separately 
or combined together. 

Diet — The diet in mortification should be of the most nour- 
ishing kind, provided the digestive powers be not too far pros- 
trated. When the tongue is dry and parched and the patient 
feverish, gum arable or slippery elm mucilage, essence of beef, 
barley water, &c. v/ill be the most suitable. But when the 
tongue is moist and cleaning, the skin warm and relaxed, the 
patient may take eggs, beef steak? mutton, chicken, wild game, 
custards, milk boiled, milk porridge, &c. In some cases of ex- 
treme debility, wine whey and even wine may be given. — 
No. 6 talven in warm water sweetened is an excellent tonic and 
stimulant. 



SE,CTIOH XIII. 



BILES. 



Treatment — In the earlier stages of biles warm fomentations 
and poultices are required to soften and relax the parts and to 
favour suppuration. 

The core of a bile consists of dead cellular tissue, and inflam- 
mation is necessary to bring on suppuration or the absorption of 
the parts surrounding the dead cellular tissue, in order to sepa- 
rate it from the living parts. It is therefore better to avoid 
opening a bile too soon, as that may interfere with the operations 
of nature, and retard rather than hasten the cure. There is a time 
however, when a bile should be opened and not allowed to break 
spontaneously, or it may destroy so much of the skin as to leave 
a large scar. 

After a bile has been opened the parts must be poulticed until 
the swelling and inflammation subside. In all running sores 
it is better to have a poultice spread on oiled silk, or something 
that will prevent evaporation. As a general rule poultices 
should be made more stimulating after an abscess or bile is 
opened than before, and if the parts be much relaxed and colder 
than natural, equal portions of composition powder and slippery 
elm will form a very good poultice. 

Washing or syringing the cavity of biles with a strong tea of 
bayberry or sumac adding a portion of No. 6, is very useful, 
it promotes granulation and assists the healing action. 

When the matter is discharged and the swelling in a great 
degree disappeared, poultices may be laid aside and salve spread 
on soft muslin or linen substituted, and wash the sore occasion- 
ally with the tea above mentioned. When the cavity of the bile 
is obstinate in healing, No. 6 may be poured into it, or wet a 
piece of lint with the drops and let it remain in the sore, applying 
a salve over the parts. 

Constitutional Treatment is not required in common cases of 
biles, except it may be to lessen pain by relaxing the system or 
with a view to prevent other biles. Biles very often occur after 
scarlet fever, measles and small pox. 



SECTIO??- XIT. 



CARBUNCLE. 



The carbuncle never occurs in a healtliy constitution. It 
snay arise from the same cause that produces biles, but instead 
of healthy inflammation observed in case of a bile, termina- 
ting in the formation of what is termed healthy or laudable 
pus, it assumes an unhealthy character accompanied by burning 
pain. The swelling assumes a dark red or livid appearance, 
and instead of pus being formed or contained in a single cavity 
and v^ith a core in the centre, as in the case of a bile, the swell- 
ing becomes soft and feels spongy and small vesicles or belbes 
are formed on the skin as in erysipelas, and an acrid fluid is dis- 
charged from numerous openings or small ulcers on the parts. — 
The fluid which escapes resembles a mixture of flour and w^ater; 
the small ulcers run together and form openings sufficient to al- 
low portions of the dead cellular tissue to escape resembling 
shreds of tow or cotton. 

The cheekj neck, and back are the parts most liable to car- 
buncle. 

Carbuncle is not in general dangerous yet it is slow in its 
progress, and difficult of cure. 

Treatment — The local treatment in the first place should con= 
sist of warm fomentations and poultices. Experienced sur- 
geons advise the early opening of the carbuncle, and applying a 
poultice made of port wine and ground flax-seed. A poultice of 
composition and elm, or of yeast and ginger may be used in the 
place of the port wine poultice. Syringing the cavity with 
strong bayberry tea, and then pouring in a portion of No. 6 will 
be of especial benefit in exciting a more healthy action in the 
parts. Local steamings will also aid the lining parts to cast 
off the dead cellular tissue. 

Constitutional treatment will be required in all cases of car- 
buncle, employing every means to correct the diseased con- 
dition of the general health, and to strengthen and support the 
constitution. In the first place the patient must be carried 
through a full course of medicine every few days and during the 
intervals use freely of composition, pepper or spice bitters. As 
the constitutional symptoms wear a more favourable aspect, clean- 
ing of the tongue, a general warmth through the body, with a 



ABSCESS OF THE FEMALE BREAST. S65 

moist skin, then tonics, such as bark and wine, quinine, gentian, 
columbo, and Virginia snake root must be given freely, and the 
patient allowed a nourishing diet, eggs, milk porridge, custards, 
beefsteak, mutton chops, boiled chicken, wild game, stale bread, 
cream, toast, &c. 

Fresh Air, — When the state of the weather and the condition 
of the patient will admit of it, he should ride or walk out to re- 
ceive the benefit of fresh air and exercise, observing especial 
care, however, to keep warm. 



SECTION XV. 



ABSCESS OF THE FEMALE BREAST. 

Gathered breast as it is commonly termed, is chiefly thoiigli 
not exclusively restricted to females after confinement It is 
generally occasioned by a large accumulation of milk, exposure 
to cold, or from sore nipples. The frequent exposure of the 
breast to the air, more especially when the skin is covered with 
perspiration is a common cause of gathered breast. 

Treatment, — As soon as the breast begins to be hard or pain- 
ful from too great a flow of milk, it should be bathed frequently 
with some evaporating lotion, whiskey, brandy, warm vinegar 
or spirits of camphor and water, or cloths applied and kept moist 
with some one of the above articles. This w ill lessen the secre- 
tion of milk. But if the breast cakes and becomes painful and 
cannot be eased by the means above mentioned together with fre- 
quently drawing the breast it should be steamed frequently, and 
covered with a plaster of salve, to keep the skin soft and moist. 
A hole must be cut in the centre of the plaster to admit the nip- 
ple. When a lump is formed in the breast from taking cold in 
the part or from irritation of the nipple, steaming the breast fre- 
quently and applying a plaster of salve, or a poultice composed 
of equal parts of green lobelia and elm, if early applied will gen- 
erally prevent suppuration, easing the pain and scattering the 
swelling. 

If the system be much disordered, an emetic or a course of 
medicine will prove beneficial in removing obstructions in the 
breast, and preventing suppuration. Placing the patient under 



^66 WHITLOW OB FELOIT. 

the influence of lobelia given in broken doses so as to occasion 
slight nausea wilt be useful in moderating pain in the breast and 
by the relaxation thus produced will aid in removing obstruc- 
tions. 

If the use of the above means fail of discussing the swelling 
and the breast continues to be very painful and throbbing, warm 
poultices must be applied with a view to favour suppuration and 
to bring the matter as speedily as possible to the surface. When 
suppuration is about to take place there is a severe throbbing pain 
in the part, and the patient experiences chilliness, and a blush 
appears on the skin covering the swelling. 

It is better to delay opening a gathered breast until the matter 
approaches near the surface. After the abscess is opened or 
breaks spontaneously a poultice composed of composition and elm 
or flaxseed; or of elm, white pond lily, and ginger must be ap- 
plied, and the poulticing continued until the discharge of matter 
has nearly ceased, when the parts may be covered with some 
kind of salve, and moderate pressure applied to favour the union 
of the sides of the cavity. 



SECTION XVI. 



WHITLOW OR FELON, 

Whitlow is an extremely painful swelling, mostly confined 
to the fingers, and particularly to the middle or last joint, or 
it is seated under the nail. 

This painful affection often becomes protracted in duration in 
consequence of pus or matter being formed beneath the tendons, 
or under the membrane that covers the bone, requiring a con- 
siderable length of time for it to find its way to the surface. 

Causes. — Felon or whitlow is sometimes caused by a bruise, 
in other instances it is occasioned by a slight wound on the skin; 
even the scratch of a pin, if frequently irritated or not protected 
from the air may aiFect the parts near the bone and produce a 
felon. Occasionally it comes on without any appreciable cause. 

Treatment — In the outset of a felon placing the hand in alco- 
hol, brandy or vinegar, und continuing it several hours at a time 
and afterwards wrapping the finger in cotton kept wet with 
spirits of camphor, alcohol, or vinegar will sometimes prevent 



WHITLOW OR FELON. S67 

the formation of matter. And even though it should fail of pre- 
venting suppuration it will mitigate the pain. A plaster com- 
posed of lime and soft soap, is a favourite remedy with some for 
whitlow or felon. 

If the swelling continue to increase attended with severe 
throbbing pain, the above or some other form of poultice must be 
kept on the parts, wetting it occasionally as it becomes too dry, 
and when there is evidence of the existence of matter in the part, 
it should be opened, either with a lancet, or in the way Dr. 
Thomson recommends, which is, to burn pieces of spunk about 
the size of a large pea, on the part until the flesh becomes dead- 
ened down to the matter, and then to open it. When this method 
is employed the hand and the diseased finger except the part on 
which the spunk is to be burned should be held in cold water du- 
ring the operation. A pair of forceps or tweezers may be used 
in setting fire to the spunk and placing it on the finger. Dr. 
Thomson does not advise this plan of burning spunk upon the 
part, until there is a purple appcarauce in the part indicating 
the approach of matter towards the skin. 

Another plan recommended by Dr. Thomson to facilitate the 
approach of the matter to the surface is to slack a small piece of 
lime on the finger. In doing this the hand should be placed on 
wet cloths, and a small roll of the same placed at each side of 
the finger to prevent the lime from falling off. A piece of un- 
slacked lime about the size of a shellbark nut is to be laid on, 
then wet, and allowed to i^emain as long as the patient can 
bear it, or until it becomes cold. This may be repeated occa- 
sionally until there is some appearance of matter, when an open- 
ing should be m?tde. 

Before an opening be made, any kind of emollient poultice may 
be applied to favour suppuration; but after pus begins to be dis- 
charged a stimulating poultice must be employed. Equal por- 
tions of slippery elm, white pond lily, and ginger form suit- 
able compound for the poultice. Indian mush, flaxseed stewed 
in milk, or any other soft substance may be employed adding a 
portion of cayenne pepper or ginger. During this stage of the 
felon the poultice should be spread on oiled silk, or a piece of 
bladder to prevent evaporation. 

When the swelling and inflammation has in a great degree 
disappeared, poulticing may be omitted, and Thomson's healing 
salve applied. 

When matter is discovered under the nail, a portion of the nail 
must be cut away to allow the pus to escape. 

When an opening is made by a lancet in the earlier stages of 
a felon the matter being deeply seated, care must be observed to 
avoid cutting open a joint. A lancet may be safely introduced 
down to the bone except immediately at the joint. 



368 



HIP DISEASE. 



Constitutional Treatment. — The pain attending a whitlow or 
felon, may be mitigated by using means to excite perspiration 
and by placing the system under the influence of lobelia, given 
in broken doses, to the extent of producing slight nausea. 

If the system be much disordered an emetic or a full course of 
medicine will be especially beneficial. Patients may sometimes 
procure sleep by having the hand raised upon pillows, and taking 
tincture of lobelia in sufficient quantities to cause slight sickness. 



SECTION XVII. 



HIP DISEASE, 



Disease of the hip joint is of very common occurrence; and 
although it prevails most among children, still the disease not 
unfrequently attacks adult persons. 

Caitses.— Although the hip disease be occasioned in many in- 
stances by a fall, yet it rarely happens in persons of sound and 
vigorous constitution. A bruise upon the hip that occasions 
scarcely any inconvenience to one of a healthy constitution, 
would be liable to cause the hip disease in one of feeble organiza- 
tion, or who is of a scrofulous constitution. 

Symptoms, — In the majority of instances of hip disease the 
first thing of which the patient complains is a pain in the knee. 
The pain is in some cases slight at first, in other instances it is 
severe from the commencement, preventing the patient from 
sleeping at night, except at short intervals. The patient is 
observed to limp and the knee becomes bent. As the disease ad- 
vances the patient complains of severe pain about the hip or 
groin, yet in some cases the pain is almost exclusively confined 
to the knee during the whole progress of the disease. 

Duration of the Disease. — The hip disease is usually slow in 
its progress, seldom terminating its course in less than a year. 
Occasionally under favourable circumstances and a proper 
course of treatment, the parts resume a healthy condition in the 
course of a few months; but unfortunately in the great majority 
of cases, the disease continues for years, though seldom attended 
with severe pain, except at intervals, and more especially in the 
early stage, and when suppuration is about to take place. 



HIP DISEASE. ^^0 

Termination. — Few patients recover from tl^e liip disease 
Without more or less distortion of the limb of the affected side. 
Sometimes the inflammation of the joint terminates in resolution, 
still this is of very rare occurrence, for the parts possess so low 
a degree of vitality that the restorative efforts of nature are in- 
sufficient to prevent disorganization of the diseased parts in un- 
healthy constitutions. A part of the body that is well supplied 
with red blood, will recover from disease much more readily than 
parts wiiich receive but a small supply of arterial blood. Hence 
the tissues about the joints receiving very little red blood are 
very slow to recover from disease; most commonly the inflam- 
mation terminates in suppuration about tlie joint, the matter 
taking different directions, sometimes pointing to the surface in 
the region of the joint; in other instances the matter travels 
down into the groin forming a fluctuating tumor; or it may pass 
down the thigii, sometimes almost to the knee. In most in- 
stances the parts finally heal but the joint remains stiff, and 
the limb shortened. The head of the thigh bone is sometimes 
entirely destroyed leaving the limb several inches shorter than 
the sound one. In very feeble constitutions the disease some- 
times terminates fatally, the powers of the constitution being 
w^orn out by disease. 

Treatment of Hip Disease in its early stage. — In the outset of 
this disease the means chiefly to be relied ui)on, are the vapour 
bath, rest, stimulating applications, occasionally an emetic, 
broken doses of lobelia, and warm teas to promote perspiration. 

The Vapour Bath may be administered daily during the early 
period of the disease. When the patient has been steamed 
twenty minutes or half an hour, he may be showered with mode- 
rately cold water, rubbed dry and bathed with vinegar or spirits. 
After the bath the hip must be covered with stimulating oint- 
ment, or W'ith salve to which a portion of pepper has been added. 
Tlie parts sliouid then be covered with oiled silk, or a rabbit skin 
or buckskin to promote perspiration and keep the parts w arm. 

Rest is very irnportant in the early period of the disease. A 
splint carved or moulded to fit the limb in a straight position or 
nearly so, may be applied with benefit in the early stage of the 
disease. It will not only favour the cure by keeping the joint 
at rest, but may prevent deformity of the limb, provided the dis- 
ease terminate without the occurrence of suppuration. After 
the disease becomes permanently fixed, then to confine the pa- 
tient with a splint will be useless or even injurious; he should be 
allowed to use crutches, and when the weather will permit to 
have the benefit of the open air. 

2 V 



S70 HIP DISEASE. 

Emetics must be given whenever tlie condition of the patient 
demands their employment. It is in the early period of the dis- 
ease however, that they are more particularly indicated. The 
proper time for giving an emetic is shortly after a vapour bath 
bas been administered. If the patient be very feeble and pale, the 
emetic of lobelia should be combined with stimulants, as compo- 
sition, pepper and bayberry, or with No. 6 and bayberry. — 
There is no period of the disease when an emetic will not 
prove of benefit if the stomach be foul, or when the patient 
is suffering severe pain. 

Broken doses of lobelia must be given frequently in the early 
stage of the complaint, more especially if the disease be attended 
with severe pain or fever. Warm teas of pennyroyal, mint, and 
ginger may be taken to promote perspiration. 

In a more advanced period of the hip disease, it will be useless 
as before mentioned to keep the parts at perfect rest, or to con- 
fine the patient by the use of a splint. Neither will it be neces- 
sary to give much medicine, except occasionally as the condition 
of the patient demands it. Cleanliness, fresh air, nourishing 
diet, salt water bath or sponging the body with salt water, and 
friction of the surface are chiefly to be relied upon when the dis- 
ease has become permanently fixed. AYhen the parts are pain- 
ful however, or the general health disordered medicine must be 
employed. 

When suppuration takes place, an abscess may be formed at 
the hip, or the pus may pass down into the thigh, forming a 
fluctuating tumour there. All experienced surgeons now agree 
that abscesses about the hip should not be opened until at a late 
period, or when the matter comes so near the surface as to threat- 
en the destruction of a considerable portion of the skin, when it 
is better to make a small opening with a sharp lancet, draw- 
ing off only a part of the matter at a time, and then closing the 
opening with a piece of adhesive plaster. 

Mscesses in the thigh often contain from half a pint to a quart 
of pus, which being secreted at the hip joint passes down between 
the muscles and thus collects in the thigh. Where an abscess is 
formed in a part thus remote from the joint it may be opened 
with safety. , „ . 

When pus is discharged either spontaneously or by opening 
the abscess, every means should be employed for sustaining the 
patient's strength; and the use of tonics, nourishing food, exercise 
in the open air, salt water bathing, a change of residence, for in- 
stance, from a city to the country? to the sea board, or to a 
moantainous or pine country should be resorted to. 



HIP DISEASE. Sfl 

Sick children are apt to be indulged in eating sweet cakes and 
various kinds of dainties between meals, which impair digestion 
and destroy the natural appetite. And although the patient have 
the gratification of eating a sw^eet cake he loses not only the en- 
joyment but the benefit of a meal. When patients w4io are reco- 
vering from sickness and more especially children, require food 
bet\veen meals it should consist of such articles as milk porrige, 
toast and milk, crackers, stale bread, custards, or crust of bread. 

Pepper Poultice,— -In the earlier stages of the hip disease and 
also after an abscess has formed, and where matter has been 
discharged and the parts remain in a pale and flaccid condition 
a poultice composed of equal portions of cayenne pepper and 
slippery elm powder may be applied occasionally with decided 
advantage. 

Warm Fomentations,-— \ni\\Q earlier stage of hip disease, when 
the parts arc painful, besides administering vapour baths, bags 
of hops, or of bitter herbs, wet w-ithhot vinegar, maybe applied 
to the hip, and kept w^arm by hot bricks or bottles of hot water. 

Pressure, — Whenever the hip will bear pressure without occa- 
sioning pain, it must be applied, with a view to support the en- 
feebled and relaxed vessels. This may be done by a bandage of 
flannel or of muslin, put around the hip. After pus has formed 
and discharged, or the parts are still secreting matter, pressure 
should always be applied, in a degree suited to the condition of 
the parts. 

Children who inlierit scrofulous constitutions are in general 
favoured with superior intelligence, so that although they m.ay 
be physically wxak, yet superiority of mental power, enables 
them to pursue professions Avhich require intellectual rather than 
muscular strength. It must be born in mind, however, that chil- 
dren of scrofulous constitution, will not bear close confinement 
in crow^ded school rooms without materially injuring their 
health. It is better in such a case that their education be neglect- 
ed, in early life, and that they receive the benefit of the open air 
which will prove the most effectual means of improving the 
constitutional health. 



SECTIOI^' XVIII. 



WHITE SWELLING. 

The knee joint is observed to be more frequently afifected with 
white swelling than any other of the joints. It seldom happens 
in others than in those of feeble constitution, and more especially 
in the scrofulous. The hip disease so prevalent among children 
of bad constitutions is a disease of the same character as white 
swelling. The hip disease prevails mostly in children under 
twelve years of age; whereas white swelling is most prevalent 
in adults. 

Causes, — The most frequently exciting cause of white swelling 
is exposure to cold. A person of a sound constitution may bear 
an exposure to cold without that inconvenience which would occa- 
sion such a degree of debility in one of scrofulous constitution as 
to cause white swelling. 

When the vitality of a part is reduced below a certain point, 
the constitution establishes inflammatory action with the de- 
sign of sustaining the vitality of the part. Thus tlie membrane 
that lines the cavity of the knee joint by the influence of cold, 
may be so far deprived of Its vitality, as to call upon the consti- 
tution for an increased supply of blood in order to prevent the 
death of the parts, and to repair the injury already sustained in 
the aifected parts. A new supply of blood is sent to tlie knee, 
an inflammatory action is established which under favourable 
circumstances may terminate in resolution — the parts being re- 
stored to a healthy action. Under circumstances less favourable 
the inflammation may terminate in adhesion — the joint being 
stiffened but without any destruction of the parts. Under cir- 
cumstances still less favourable, for instance, where the consti- 
tutional health is very bad, or the vitality of the diseased parts 
reduced beyond the power of reparation, then suppuration of the 
parts will take place, matter will be discharged, and the disease 
necessarily become of long continuance and extremely painful. 
Portions of bone are destroyed in many instances by the process 
of absorption. 

Treatment — The indications for the cure of white swelling are 
to correct and support the general health, and to employ 
such local means as will aid in bringing the inflammatory 
action in the diseased parts to a favourable termination — either 



WHITE SWELIIJ^TG. S7S 

in resolution, or ancliylosis (stiffening of the joint) or if suppu- 
ration occur, to favour the occurrence of adhesive inflammation 
and stiffening of the joint which will he the only *^ safeguard of 
the patient," after suppuration has taken place. 

An occasional course of medicine should he administered in 
the earlier stage of the disease, or at any period when the pa- 
tient is suffering severe pain. 

Besides the course of medicine the spice hitters should he taken 
two or three times a day, and a dose of composition or of bay- 
herry and pepper at night. These remedies however, may be 
given in a different form, to suit the fancy of the patient. Thus 
the No. 3 pills will supply the place of the bayberry and pepper, 
and when the tongue is dry the compound lobelia pills will he 
appropriate. 

Injections moderately stimulating and containing a portion of 
lobelia will be useful not only to assist the action of the bov/els, 
but by the influence which they exert over the circulation of 
the lower extremities. An injection of composition tea, adding 
a portion of lobelia powder, retained fifteen or twenty minutes 
or allowed to remain in the bowels, will seldom fail of relieving 
pain in the diseased limb, and it it will also in many instances 
cause free vomiting. 

Tonics. — In a later period of the disease and more particularly 
where suppuration has taken place and the parts are discharging 
matter, bitters may be employed with a view to strengthen the 
digestive powers so as to allow the patient to take nourishing 
food, to support the constitution in her curative efforts. In the 
earlier stages of the disease, composition, pepper, spice bitters 
and lobelia are generally indicated, whereas in its more advanced 
stages, tonics, syrups, generous diet, fresh air, and gentle ex- 
ercise are called for. 

Local Treatment — In tlie earlier stages of white swelling, and 
all affections of this character steaming and fomentations will 
be found beneficial. The steam may be applied for half an hour 
or even an hour at a time, and after this the stimulating lini- 
ment may be applied to the parts, and then bind them up in oiled 
silk or flannel. The limb must be kept warm and at rest. In 
the place of applying the steam in the usual way, tlie patient sit- 
ting in a chair, a bag filled with boiled potatoes, or with hops 
wet with vinegar, may be kept to the parts constantly, keeping 
a hot brick to the bags, or have two and change them so as to keep 
one constantly warm to the parts. This latter method is gene- 
rally to be preferred, as by it a regular warmth may be applied 



374 ITLCERS. 

many hours or even days, without putting the patient under the 
necessity of sitting up. 

Bandages.—KveYi in the earlier stages of white swelling, mo- 
derate pressure will be beneficial provided it can be applied with- 
out occasionisig too much pain, if the disease be in the knee joint 
the limb must be bandaged from the end of the foot to the knee, 
first applying stimulating ointment, No. 6, or pepper sauce. 

Dr. Thomson^ Foultice for JVhite Sivelling. — Take fresh 
cooifrey root and scrape or grate it fine until you obtain half a 
pint. To this add the white of two or three eggs well beaten? and a 
gill of brandy, or sufficient to make it of a proper consistence for 
a poultice; spread this and bind it on the affected parts as firmly 
as can be borne, renewing it as often as it becomes dry. Wiien 
the parts suppurate, the disease becomes extremely painful and 
protracted in some cases to several years duration. In severe 
cases the constitution may become exhausted, the patient sinking 
under the effects of the disease. 

In treating this and every other disease attended by inflamma- 
tion it should be borne in mind tbat inflammation is not the first 
change in the parts from a healthy condition. Coldness and 
loss of vitality in the part is the first change from a healthy 
state, and inflammation follows as an effort of the constitution to 
preserve the vitality of the parts, and protect the joint from de- 
struction; and although these efforts are frequently baffled from 
want of constitutional energy, or from great debility of the parts 
diseased; still the design of the inflammation is the same, and 
the treatment should be directed to correct and support the gene- 
ral health and to promote the circulation in the diseased joint 
hy the various means already mentioned. 



SECTION XIX. 



ULCERS. 



Some medical writers divide ulcers, into three classes, namely* 
heaWujj unhealthy, and specific ulcers. An ulcer is generally of a 
healthy character where it occurs in one of a Iiealthy constitution, 
and more especially in the young and robust; whereas the aged 
and feeble, and especially those of intemperate and desolate 
habits are subject to ulcers of an unhealthy character, and very 



qLJLCER. 375 

difficult of cure. Syphilitic, cancerous, and scrofulous ulcers, 
are generally considered as being of a specific character. 



SECTIOIS^ XX. 



SIMPLE OR HEALTHY ULCER. 

Causes, — Simple ulcer arises from some local injury, a bruise, 
cut, or burn; or it may follow abscesses or biles. 

Characteristic marks of the healthy Ulcer. — The surface of this 
ulcer has a florid appearance, raised above the edges, discharges 
a creamlike pus, that has no odour; *^ and the edges of the sore 
are whitish and nicely adapted to the surface.'* 

Treatment. — The simple healthy ulcer seldom requires any 
thing more than to be protected from the air by the application 
of some simple sahe. 

A healthy ulcer may become converted into one of an un- 
healthy character by frequent exposure to the air or toother in- 
jurious influences. If proud flesh rise up in the sore, a poultice 
of finely powdered marsh rosemary, bayberry, or alum, must be 
sprinkled upon the parts and salve applied; or instead of the 
powder apply dry lint to the proud flesh, cover the edges of the 
sore with salve, and apply moderate pressure to the sore. 



SECTION XXI. 



UNHEALTHY ULCER. 

A?f unhealthy ulcer may be extremely irritable inflamed and 
painful; or it maybe indolent and almost devoid of sensibility — ■ 
In aged persons a bruise upon the skin is apt to occasion an un- 
healthy ulcer, '* the parts being too weak to carry on the actions 
necessary to its recovery.'^ 

A great diversity of appearances are presented by unhealthy 
ulcers. 



376 ULCEUS. 

The irritable ulcer is generally cliaracterizd ^'observes Doctor 
Gibson" by the following appearances. The edges of the sore 
are ragged, undermined, and sometimes almost serrated. The 
parts for some distance beyond the ulcer are red and inflamed 
and often (edematous. Irregular hollows occupy the bottom of the 
ulcer, and contain a thick greenish or reddish matter, which is 
so extremely acrid as to excoriate tlie adjoining skin. In place 
of granulations may be found a white or dark red spongy mass, 
extremely painful and shedding blood upon the slightest touch." 

^^Iiijlamed Ulcers. — Here you have a serous discharge from 
the sore; a bloody ichor, composed of serum and the red particles 
of blood; a disposition in many cases to slough; the surface 
covered with a brown incrustation; and the skin and surround- 
ing parts highly inflamed." Castle^s Manual of Surgertj, 

*^ Gangrenous Ulcers, — In ulcers of this kind, the surface is per- 
fectly free from any discharge; the surrounding edges of a livid 
appearance, with small vesicles or blistered spots on them; and 
the patient suifers much from irritative fever." 

Indolent Ulcer. — This is the most common kind of ulcer. The 
edges of the sore are raised, and rounded, giving the appearance 
of a deep cavity to the ulcer. The surface of the sore is cover- 
ed to a greater or less extent with a slight coloured crust, and is 
extremely insensible to the touch. In general there is a free 
discliarge of a tenacious matter from the sore, differing essen- 
tially from healthy pus. This kind of ulcer is in almost every 
instance seated on the leg. and the nearer it is to the ankle the 
more difficult it is of cure. 

TREATMENT OE UlfHEALTHY ULCEES. 

Constitutional treatment is in general necessary in the cure of 
unhealthy ulcers, besides its influence in exciting a healthy ac- 
tion in the vessels of the diseased part; a proper course of consti- 
tutional treatment secures the constitution from the bad conse- 
quences that might otherwise ensue from the healing of long 
standing ulcers. I have known ulcers of many years standing, 
to be entirely healed in a short time, under Thomsonian treat- 
ment and the general health of the patient still continue to im- 
jjrove. 

Unhealthy ulcers w ill in many instances be observed to assume 
a more healthy appearance, after the patient has been carried 
through a course of medicine. In cases of long standing the va- 
pour bath and emetic, or a full course of medicine will be re- 



tJLCER. 377 

quired to be administered as often as every week or two, and re- 
peated several times, together with the daily use of stimulants, 
capsicum, composition, anti-canker medicine, and tonics, and 
a proper course of local treatment, before the sore will assume a 
healthy condition, and secrete the cream-like pus, observed in 
healthy ulcers. 

In confirmed drunkards, ulcers are often very difficult 
to heal; constitutional and local treatment proving ineffectual, 
so long as the habit of excessive drinking is continued in. 

Besides an occasional course of medicine, the following plan 
of giving the medicines (first proposed to me by Dr. A. C. Logan) 
I have found well adapted to almost every case of chronic disease, 
namely: A dose of Thomson's anti-canker medicine in the morn- 
ing before breakfast, a dose of the No. 4 bitters before dinner, 
and composition at bed -time. If tlie bowels be costive, from 
three to six of the compound lobelia pills should also be taken at 
bed-time. 

-Dr. LogarCs Mterative Syrup. — This syrup is made by com- 
bining equal portions of tincture of lobelia, No. 6, and simple 
syrup of sugar. To be taken in doses of from one to two or 
three teaspoonsful, repeating the dose several times a day, but 
particularly sliortly after or within an hour or two after meals. 
The use of this syrup fulfils many important indications for im- 
proving the general health. 

Sarsaparilla Sijriip. — In mercurial syphilitic, or scrofulous 
ulcers, the simple syrup of sarsaparilla, or a syrup made of a 
compound of sarsaparilla, guiac shavings and yellow dock root, 
will be found useful. 

Local Treatment in Unhealthy Ulcers. — In the first place, sti- 
mulating and astringent washes aiid poultices must be employed 
to stimulate and give tone to the enfeebled vessels; and when 
the ulcer has begun to secrete thick yellow or cream-like 
matter, and healthy granulations are formed upon the surface of 
the ulcer, then fresh salve may be applied: or shave the iiair 
from the skin around the ulcer, and apply strips of adhesive 
plaster, which should encircle about two-thirds of tlie limb, 
pressing the edges of the ulcer towards eacli other when the ad- 
hesive straps are put on, and leave small interspaces between 
the straps, for the escape of pus or whatever secretions may be 
formed. If the ulcer be on the leg, the limb sliould be bandaged, 
commencing at the end of tlie foot and extending the bandage 
above the ulcer, so as to apply moderate and equable pressure to 
the limb. This will, in general, enable the patient to walk out, 
or to pursue his daily avocation, the bandage furnishing support 

2 yv 



378 tJtCERS« 

to the blood vessels and aiding them to carry on the circula- 
tion. 

Indolent ulcers may require actively stimulating poultices, 
such as a compound of cayenne pepper, bayberry and elm, or of 
composition powder. Dr. Samuel Thomson informed me that 
he had cured indolent ulcers by applying the dry powder of 
cayenne pepper, brown lobelia and bayberry, and then adminis- 
tering a course of medicine. 

Another plan of treating unhealthy ulcers, is to fill the ulcer 
with bees- wax and Burgundy pitch melted together and applied 
as 'warm as the patient can bear. This is to be bound on, and 
renewed as often as may be required. 

Change of Remedies. — Every one who has treated ulcers of 
long standing must have observed the utility of occasionally 
changing the local treatment. An application that will answer 
well at one time may prove useless, or even worse than useless, 
at another. 

The extract of red clover, (Thomson's cancer balsam) has 
been highly recommended by some practitioners of the old school 
as a valuable remedy in indolent ulcers. The extract of sheep 
sorrel may be used for the same purposes. 

It must be borne in mind, however, that in cases of long stand- 
ing sores, a course of medicine should be administered and re- 
peated if necessary, in order to prevent any bad effects that 
might otherwise arise from the healing up of ulcers. 

To Fr event a Eeturn of Ulcers.— When an old sore has healed, 
the part should be bound in flannel, wetting it every day with 
No. 6. The flannel will not require changing, as the myrrh 
will prevent its becoming in the least degree offensive. Beja- 
min Thomson, formerly of Boston, showed me a flannel bandage 
that he had worn around his shin two years, and by having it 
wet occasionally with No. 6, it was entirely devoid of offensive- 
ness, and afforded a protection against ulcers, of which he had 
been many years subject to. 

Gangrenous Ulcers. — **In ulcers of this kind, the surface is per- 
fectly free from any discharge; the surrounding edges of a livid 
appearance, w ith small vesicles or blistered spots on them; and 
the patient suffers much from irritative fever." 

Treatment. — Where a part is threatened with gangrene or 
mortification, the yeast poultice should be applied, aud the pa- 
tient carried througli a course of medicine, followed by the 
free use of cayenne pepper tea, third preparation of lobelia in 
bayberry tea; the compound lobelia pills, ginger or composi- 
tion tea. As nourishment give wine whey, essence of beef, or 



ULCERS. 579 

any other kind of nourisliing food that may suit the condition of 
the stomach. 

If the parts be excessively hot and inflamed, the poultice may 
be kept wet with the tincture of lobelia, simple water, or with 
wild indigo root tea. 

Ulcers arising from disease of the Veins, — The veins of the leg 
are more liable to disease than veins in any other part of the 
system, giving rise to the formation of ulcers along the 
course of the larger veins. The circulation of the blood being 
impeded or obstructed by the diseased condition of tlie vein, ad- 
hesive inflammation is established, forming a small tumour un- 
der the skin; tlie skin over the tumour is observed first to 
roughen and peel off", and then a crust is formed, and finally an 
ulcer breaks out. These ulcers may, in most instances, be heal- 
ed without great difliculty, but the vein continuing diseased, new 
ulcers are formed, and in this way they may continue to break 
out until by frequent ulceration the vein becomes obliterated, 
when tlie ulcers will cease to return. 

Treatment — Besides adopting tlie usual means for restoring 
the general health, when it is disordered, tlie limb upon which 
the ulcer or ulcers exist must be accurately bandaged from the 
foot to the knee, or a laced stocking worn, for the purpose of 
supporting the debilitated veins of the leg and to assist them to 
to carry on the circulation, by which the tendency to obstruction 
will be lessened. 

In the selection of local application for the ulcer we must be 
governed by the circumstances of the case. If the parts around 
the ulcer are swollen and inflamed poultices must be applied, 
until the inflammation subside when fresh salve may be substi- 
tuted. When tlie ulcer is slow in healing finely pulverized bay- 
berry, alum root, or marsh rosemary should be put into the ulcer 
dry, every time it is dressed, and salve spread upon oiled silk or 
a poultice applied. 

Friction, — Rubbing the limb briskly every morning and even- 
ing may prevent the formation of new ulcers by removing obstruc- 
tions to the circulation of the blood in the veins. 

Best and Position, — When the ulcer is in an irritable condition 
and the parts surrounding it swollen and inflamed, the patient 
should refrain from walking much, but keep at rest, with the af- 
fected limb elevated on a chair while sitting up. If the patient 
have been afl\?cted a considerable length of time with this form 
of ulcer, it may be worse than useless to confine iiimself to the 
house, provided the condition of his general health and the state 



380 GONORRHCEA. 

of the weather will pisrmit of his going out. The limb must be 
bandaged or a laced stocking worn always, when the patient is 
walking about, or pursuing his usual avocation. 

Steaming — In many instances benefit will arise from steam- 
ing the legs occasionally when affected with varicose ulcer. The 
vapour may be applied as hot as can be borne, and this continu- 
ed from half an hour to an hour, or even longer at a time. Af- 
ter the steaming the limb may be rubbed over with stimulating 
ointment. 

ULCERS UNDER A NAIL. 

Ulcers sometimes form at the root of the nail, which may con- 
tinue to prove a source of annoyance for months or even years, 
unless the dead portion of the nail be removed. Sometimes it be- 
comes necessary to remove tlie whole of the nail before the parts 
will heal soundly. If llie root of a nail become separated from 
the surrounding parts by ulceiation or by an injury the nail will 
operate as a foreign body, keeping up a continual irritation and 
ulceration of the parts until it is removed. 



CHAPTER XYIf. 



SECTION I. 



VEXEREAL DISEASE, 



The term venereal disease is applied to two forms of disease 
differing essentially in their general aspect. The one in the male 
consisting of an inflammation in the urethra attended by a dis- 
charge of tliick mattei'; whilst the other is an ulcer called chan- 
cre situated externally to tise urethra. 

GONORRIiCEA. 

<S^?/7n]?fo7Jis.— Tlic first symptoms arc a burning sensation on 
passing water, arconipanicd with inflammation and a discharge 
of thick matter from tiie urctlira. In the course of a few days 



GONORIllKEA* 38 J 

the burning sensation on passing urine, subsides, but the inflam» 
mation and discharge of matter seldom disappear under eight 
or ten days, and very frequently continue many months. 

In the female the symptoms are much more obscure, and so 
closely resemble diseases arising from other causes than venereal 
poison that in many instances it is difficult to form an opinion as 
to the true character of the disease without having a history of 
the case, and even then an erroneous opinion might be formed by 
even experienced physicians. 

It should also be borne in mind that men are liable to disease 
of the urethra resembling gonorrhoea in many particulars, but 
arising from causes wholly distinct from that of gonorrhoeal poi- 
son. The peace of families lias in some instances been destroy- 
ed, by a wife or husband being affected with symptoms resem- 
bling those attending the venereal disease, at the same time the 
accused party is entirely innocent. Instances have occurred in 
which symptoms of gonorrhcea have occurred in men, in conse- 
quence of the wife being affected with a severe form of fluor albus, 
or whites, each party accusing the other of infidelity. 

Of the general course of the disease in the male — Under proper 
treatment and with great care and attention on the pai't of the 
patient in relation to diet, rest, &c., the disease will in many in- 
stances disappear in the course of a week or two. It often hap- 
pens however that the disease is neglected in its first stage, tlie 
patient being unwilling to make his disease known; or he will 
not lie by without some plausible excuse for so doing, in order 
to evade suspicion, by which course tl»e disease is often aggra- 
vated and becomes protracted to many months duration. 

Where the general health is much disordered, and the patient of 
a scrofulous constitution, want of proper care and treatment, the 
use of improper remedies, or wlien the venereal poison has been 
of the more malignant character, the disease is very liable to be- 
come extremely harassing and painful. The inflammatory ac- 
tion in the urethra failing to overcome the disease, either from 
the debility of the parts, neglect, or from improper treatment, 
then it generally happens that lymph is thrown out in the parts 
along the course of the urethra forming a hard cord and w^hen 
erections occur as they often do during sleep from the determi- 
nation of blood to the parts, it occasions what is termed chordee 
which is so extremely painful that the patient is induced to jump 
out of bed and apply cold water to the pai*ts, and this in many 
instances has to be repeated many times during the night. 

These erections are not only extremely annoying to the pa- 
tient, but tliey aggravate the symptoms and cause the disease to 
become more protracted in its duration. 

Where the disease has been of long continuance, the patient is 



382 GONORRHCEA. 

in most instances left with wliat is termed gleet, consisting of ti 
slight discharge from the iiretiira of a trans])arent mucous, re- 
scmhling the wliite of an e§^, whicli is the effect of a weakened 
condition of the ])arts. 

In the female the disease is mucli less trouhlesome; in many 
instances causing little inconvenience, and is also much more 
readily cured. 

Treatment — In the first stage of gonorrhea the patient should 
avoid using much exercise. His diet should he restricted to the 
lightest kinds of food, such as gruels, stale bread, toavst and tea, 
&c. A gruel made of elm or of unbolted v/lieat flour are well 
suited to the early stage of gonorrhea. The digestive powers 
are in general more or less weakened during the eai*ly stage of 
the disease, and if food be taken that is hard of digestion, it will 
retard the cure. And again, if strong food, sucli as butter and 
meat be used, the urine will be more acrid and irritating to the 
inHamed urethra. 

When the general health is in a bad condition, or the patient 
feverish, or the skin dry and harsh, a course of medicine will be 
particularly serviceable; after which tlie patient should take 
every hour or two a small dose of lobelia, either in flse form of 
tincture, powder, or in pills; drink freely of elm gruel, flax seed 
lea, barley or gum arabic water; and morning and evening take 
a tcacupful of a strong decoction of sumac or bayberry. The teas 
should be taken warm, with the view to promote perspiration, 
which is of much importance in the early stage of the disease, 
provided the patient remain in the house. 

If the bowels be costive they must be relieved by injections, 
comj)osed of composition, bayberry, or pennyroyal tea, adding 
a teaspoonful of tlie tincture or powder of lobelia. 

External Applications. — Buring the first period of the disease, 
and particularly if there be much heat and an undue accumula- 
tion of blood in the parts, wet cloths should be applied and kept 
wet with warm water, and occasionally with the tincture of lo- 
belia, or with alcohol, or whiskey and water. This by prevent- 
ing too great a collection of blood in the part will relieve the 
symptoms, and may shorten the duration of the disease. In 
many instances, however, the patient to avoid suspicion and 
to conceal his unfortunate condition, continues to pursue his usual 
avocation, without applying the proper remedies, by which 
the disorder becomes aggravated and its duration very much 
lengthened. 

In the early stage of the disease the tincture or a tea of lobe- 
lia dropped into the urethra shortly after passing water, will 
facilitate the termination of the inflammation. 



ieoNoiiRncaiU 383 

In a more advanced stage of the disease. — After the passing of 
ui'iiic ceases to cause burning sensations, then astringent and 
stimulating injections into the urethra will be useful; commen- 
cing with a simple tea of baybery or sumac adding a small por- 
tion of the tincture of lobelia. In a still later period of the dis- 
ease the discharge having been for some time profuse, a portion 
of No. 6 or pepper must be added to the tea in sufficient quantity 
to make a sensible impression on the urethra. I have known 
undiluted No. 6 to be used in some chronic cases for injections. 

Balsam Copaiva. — This article is much used for the cure of 
gonorrhoea, and when pure and taken at a proper time, it is a 
valuable remedy. It should not be used in the first stage of 
tlie disease, nor until the inflammatory symptoms have abated. 
Neither should it be employed if the patient be feverish, the skin 
being hot and dry, the tongue coated, redder than natural and 
inclined to dryness. Under these circumstances the balsam is 
almost sure to disagree with the stomach* In general this medi- 
cine may be used to advantage in the course of ten days or two 
weeks from the commencement of the disease. If the symptoms 
do not imj)rove under its use in the course of a few days it should 
be laid aside for the time. The dose and methods of preparing 
may be seen in the materia medica under the head of balsam co- 
paiva. 

Chordee as it is termed depends upon the deposition or extra- 
vasation of lyinyii in the parts along the course of the urethra, 
wliich feels hard like a cord. This condition of the parts oc- 
casions severe pain at times, more especially at night, compell- 
ing the patient to apply cold water to the parts to ease the pain. 
The local treatment for chordee consists in the use of fomenta- 
tions and poultices. In the commencement of chordee, its further 
progress may often be checked by steaming the parts an hour or 
two by placing a hot brick in a basin containing a small portion 
of water, and sitting over the steam, or wrap a hot brick in damp 
cloths and place it as near the parts as can be borne, in bed. A 
poultice composed of elm, white pond lilly, and green lobelia, 
should be kept on the parts during the night and through the day 
applying salve spread upon oiled silk. The poultice should also 
be spread upon oiled silk to prevent evaporation. 

When the patient is about his usual avocation, the compound 
lobelia pills may be taken three or four times a day. Camphor 
appears to have a benefical influence in checking the symptoms 
of chordee. A piece of guui camphor the size of a large pea to 
be taken at bed-time, together with three or four lobelia pills. 

After the symptoms of chordee have subsided the poulticing 



384 GONORRHffiA. 

mRj be omitted: still some kinO of salve should be used in the 
way above described. 

Wliere the disease has continued several months^ but unattended 
with chordee, the parts being in general colder than natural, then 
injections must be employed frequently, with a view to excite 
healthy action in the debilitated vessels of the mucous membrane 
of the urethra. Equal portions of bayberry and poplar bark 
tinctured in No. 6 form a suitable injection in cases of long stand- 
ing gonorrhoea or in gleet. 

Iw females this disease is to be treated upon the general plan 
already described, except that the injections are to be adminis- 
tered to the vagina instead of the urethra. In females where 
the disease has continued several weeks, a sponge wet with bay- 
berry or sumac tea and No. 6, should be introduced into the va- 
gina, allowing it to remain two or three hours, and then changed 
for another pi*epared in a similar way, and in this way continue 
these applications several days together, unless they be found to 
disagree. 

SYPHILITIC SORE, OR CHANCRE. 

This species of tise venereal disease differs materially from 
the one just treated of. It usually commences with the forma- 
tion of a pimple, surrounded by inflammation. As the disease 
progresses an open sore or ulcer is formed, termed chancre. — ■ 
Wiien the chancre is seated upon the skin and does not advance 
more deeply, it may in general be cured without much difficulty; 
but wiien it is situated on the glans penis, it is more difficult of 
cure, or at least it requires a longer time for a cure to be effect- 
ed. In individuals of depraved and filthy habits, and under other 
unfavourable circumstances, as where mercury is given, the sy- 
philitic sore sometimes assumes a highly malignant character, 
occasioning extensive sloughing of the parts. The poison may 
likewise become absorbed and carried into the system, occasion- 
ing what are called the secondary symptoms of syphilis. A 
swelling in the groin termed bubo, is a very common attendant 
upon chancre. 

Treatment. — An important point to be kept in view in treat- 
ing syphilis, is to prevent it from extending to the system. 
For this purpose no plan of treatment probably can be adopted 
with so nuich certainty of success as a course of medicine given 
every day or every few days in the commencement of the disease; 
and during the interval between the courses, to place the system 
under the influence of lobelia, taken in small doses; together 



GOXORRHCEA. 385 

with tlie use of composition and injections to regulate the 
bowels. 

A course of medicine will not be necessarily required in every 
case of this disease, still its operation will prove beneficial in 
all cases, and in all stages of the complaint, and when the disease 
has a malignant character, it must not be omitted. 

Local Treatment — The sore in the commencement should be 
poulticed with a compound of elm, white pond lily, and lobelia 
powder, wet with the tincture of lobelia, and spread upon oiled 
silk, bladders, or something that will prevent the poultice from 
drying rapidly; or if the sore be so situated that a poultice can- 
not be applied to it, it should be wet with the tincture of lobelia 
several times a day. 

When an open sore or ulcer is formed the poulticing should be 
continued, wetting the ulcer two or three times a day with No. 
6, or with the liquid of the third preparation of lobelia. 

Chancre is seldom cured under two or three and very often 
it continues for six weeks. 

Patients very naturally become dissatisfied with the treatment, 
and are induced, unless they discover a manifest improvement 
in the condition of the sore, to make a change, under the errone- 
ous idea that they may find a remedy that will eradicate the dis- 
ease in a few days. Dishonest and ignorant empirics who adver- 
tise to make a speedy cure in all cases, arc applied to, but failing 
to cure, others are applied to, and thus by frequently changing 
the treatment, the disease becomes aggravated and protracted 
much beyond what it would have been if it liad been left entirely 
in the hands of nature. A man who advertises to cure the vene- 
real disease in a short time, and without fail, may be set down at 
once as one who depending upon the credulity of others for sup- 
port, has sacrificed honesty and truth for motives of gain. The 
reason why the failures of these empirics are not more generally 
known, may be readily seen. No one who has the venereal dis- 
ease will expose himself in order to expose those who have decei- 
ved him and fleeced him of his money. 

The medical profession though more honourable in general 
than the class above alluded to, have not as yet settled upon any 
general plan of treating syphilis. The opinion of the great 
guns of the profession concerning the effects of mercury in this 
disease, have been, and still are extremely various. Formerly 
it was believed that mercury was a specific for syphilis, not be- 
cause it proved to be a specific, but because high authority had 
pronounced it to ftesuch. More recently, however, this doctrine 
has been exploded by the highest autliority in the profession, and 
the use of mercury not only declared unnecessary in the cure of 
syphilis, but pernicious in the extreme, unless given with the 

2 X 



386 GOJrOBEHOEA. 

greatest caution. Professor Gibson, of this city, in his work on 
surgery, recommends the use of mercury in cases of chancre, but 
he now honestly declares mercury to be altogether improper, 
tending to convert a simple chancre into one of a malignant or 
corroding character. P. Ricod, surgeon to the Venereal Hospi- 
tal of Paris, in a recent ** Treatise on Venereal Disorders,'' in 
the course of his observations on the employment of mercury in 
chancre observes: ** By one party it is declared, that no cure can 
take place, no repose be enjoyed, no future health anticipated un- 
less mercury be used, and by the other, future disease and death 
are predicted if this remedy be employed." " Again," observes 
the same writer, "Prejudice attaches us to the principles in 
which we are educated, and renders them objects of affection; 
and hence the obstinacy with which men cling to ideas with 
which they are familiar. The experience of the world has shown 
that partisans are sternly adhesive; that truth is more frequent- 
ly imagined than perceived; that the value of a reason is too 
seldom accurately measured; and that minds satisfied with par- 
tial knowledge, far out-number the warm conscientious lovers of 
philosophy. We can readily perceive the reason why men 
spurned the great principle promulgated by Rose and Thomson. 
It was a heavy blow aimed at a favourite and long cherished 
opinion; but the truth will stand fast, despite the efforts of the 
boisterous declaimer, or the insidious endeavours of the smiling 
sophist. Rose and Thomson demonstrated an important truth, 
they incontrovertibly proved, that mercury is not necessary to 
the cure of chancre as chancre; and this the intelligent ingeni- 
ous mind will acknowledge, however much it may dissent from 
their method of applying it." 

When chancre is accompanied with a high degree of inflam- 
mation or swelling, the part should be steamed two or three 
times a day, and a moist warmth constantly applied, either by 
means of a hot brick or bottle of hot water wrapped in damp 
cloths. This course of treatment may be employed with advan- 
tage in any stage of the complaint. And when the disease 
wears a malignant aspect, it must not be omitted. 

When the ulcer has been discharging freely for sometime, the 
sore should be filled every day with bayberry, marsh rosemary, 
or alum root, finely pulverized, put in dry, and the whole cover- 
ed with salve spread upon oiled silk. 

The ulcer is sometimes so situated that it cannot be reached 
except by injections; for instance, when its seat is on a part 
where the skin is drawn over, and swollen to such a degree that 
it cannot be drawn back. Under circumstances of this kind lo- 
cal steaming and warm fomentations must be employed, and the 
sore syringed often with lobelia tea, or tincture of lobelia; and if 



GOXOJIIIHCEA. SST 

there be a free discharge of matter, bayberry tea must be em- 
ployed, adding tincture of lobelia and No. 6. 

Whenever a syphilitic ulcer is extending, it is necessary to 
apply active stimulants, as No. 6 and the third preparation of 
lobelia, with the view to excite adhesive inflammation in the 
cellular tissue to prevent the further extension of the ulceration. 

"When a chancre discharges matter freely, the dressing must 
be changed frequently, and every precaution used to prevent 
other parts from being inoculated with the poison; whereas when 
the sore is in a healing condition, the dressing should not be re- 
moved oftener than twice in twenty-four hours. A good plan of 
dressing a healing sore is to cover the edges of the ulcer with 
salve; and to apply lint to the centre of the ulcer, the sore then 
may be dressed without disturbing the healing process going on 
at the edges. 

The practice of destroying the syphilitic pimple or ulcer as 
soon as it appears or within the first few days, hy applying lunar 
caustic, is strongly advocated in a " Practical Treatise on Ve- 
nereal Disorders," by Philippe Ricord, M. D. surgeon to the 
Venereal Hospital of Paris. In the case of a pimple this writer 
recommends that it be cut open, and then apply the caustic, 
which should be pointed, when the sore is small, so that the 
bottom of it may be effectually cauterized. 

Ricord states that if this treatment be applied early a chancre 
may usually be cured in eight or ten days, when it would require 
several weeks if left alone to run its course. If this declaration 
can be substaiitiated by experiment the practice should certainly 
be adopted. It generally happens, however, that a physician is 
not applied to in this disease until the lapse of several days or 
even weeks after its first appearance. 



BUBO SWELLING IN THE GROIN. 

Both gonorrhoea and syphilis are apt to occasion a swelling 
in the groin, termed bubo. When a bubo is occasioned by 
gonorrhoea, it very rarely suppurates; but when it arises from 
the absorption of syphilitic viris, suppuration is apt to take 
place. 

Treatment — Warm fomentations, volatile liniments, or lo- 
tions, and protecting the parts from cold, are all that will be re- 
quired in the local treatment of bubo attending gonorrhoea. 

When bubo occurs in one who has a syphilitic ulcer, the pa- 
tient should keep in bed, and cotton wadding or soft muslin 
cloths wet with the tincture of lobelia applied to the parts, and 



588 GONOUEHCEA. 

retained by Iiiiving a bandage placed around tlie hips and another 
passing under the thigh, over the groin and fastened to the hip 
bandage. 

The patient should also be placed under constitutional treat- 
ment. A full course of medicine is the most efficient method of 
treatment that can be devised — it is suited to all cases, and to all 
stages; it harmonizes with nature and aids her efforts to work 
off disease. The courses of medicine are to be repeated as the 
exigencies of the case demand. In the milder cases, unattended 
with much swelling or pain in the groin, and where the general 
health is not prominently disordered, a course of medicine may 
not be demanded: here the patient should keep warm in bed 
take the compound lobelia pills to the amount of from ten to fif- 
teen pills every day; regulate the bowels by injections; and take 
a dose of ccmiposition, or of bayberry and pepper two or three 
times a day. 

When the swelling in the groin is very painful and throbbing, 
poultices must be applied with a view of favouring suppuration. 
The poultice so often mentioned, consisting of elm, ginger, white 
pond lily and cracker, may be employed, until the bubo is 
opened or breaks spontaneously, w hen a more stimulating and 
astringent poultice must be employed, such as equal portions of 
composition and slippery elm; or to the first mentioned compound 
add a portion of capsicum and bayberry, the poultice being 
spread upon oiled silk to prevent evaporation. If the parts do 
not heal readily the cavity of the bubo should be syringed every 
morning and evening with bayberry or No. 3 tea, adding a por- 
tion of No. 6. When the swelling has subsided, and the parts 
become relaxed, lint wet with No. 6 may be introduced into the 
cavity of the abscess and some kind of plaster applied to exclude 
the air from the parts. 

SECONDARY SYMPTOMS OF SYPHILIS. 

From the want of proper treatment of chancre and more es- 
pecially where the patient has been subjected to a mercurial 
course of treatment for the disease, the syphilitic poison may be 
absorbed and carried into tlie blood, and finally become seated 
either in the mouth, throat, nose, bones, or upon the surface of 
the skin. 

When the disease attacks the roof of the mouth, an ulcer is 
formed, the bone is made bare and exfoliates, forming an open- 
ing between tiie mouth and the cavity of the nose, and changing 
the sound of the voice. 

If the disease be seated in the tonsil, an ulcer is formed, pre- 
senting the clsaracter of chancre. When the mucous mem- 
brane of the nose becomes diseased by the syphilitic poison, the 



GONORUHGEA. 3S9 

patient is very liable to lose some portion of the bones of the 
nose. 

Sometimes the secondary symptoms of syphilis appear in the 
form of copper coloured eruptions on the skin. These eruptions 
are slightly raised, scarcely ever painful, but are apt to itclt 
especially in the after part of the day. 

**There is a greater variety of character in these venereal erup- 
tions than in any other symptoms of the complaint; not only in 
appearance but also in size. In some you will find the eruptions 
of considerable magnitude, appearing as if a portion of copper 
coloured skin laid upon the surface, but unattended with ulcer- 
ation. In others you will observe deep ulcerations with a rag- 
ged edge; in a third, there will be scaly eruptions, covering very 
large surfaces in various parts of the body." Syphilitic erup- 
tions are generally readily cured. 

When the disease attacks the periosteum of the bones, " the pa- 
tient experiences in the evening a sensation of pain in the bone, 
which afterwards becomes the seat of the node* The pain does 
not immediately produce a swelling; but in the course of a few 
days, a painful swelling appears in the evening, which disap- 
pears again on the following morning, and leaves no pain. At 
this time the periosteum (membrane that covers the bone) only 
becomes affected with inflammation; in a short time a deposit 
takes place between it and the surface of the bone; this deposit 
is, in the first instance, only a serous fluid, but a cartilaginous 
substance is soon secreted, which is gradually converted into 
bone, and is technically called a node. 

Treatment of the secondary symptoms of Syphilis, — Whatever 
part may be the seat of the disease, the same general constitu- 
tional treatment will be demanded in each case. The vapour 
bath, an occasional course of medicine, together with the use of 
spice bitters, composition, Dr. Logan's alterative syrup, sar- 
saparilla syrup, and compound lobelia pills are the means and 
remedies chiefly to be employed. 

When an ulcer is formed on the roof of the mouth, it should 
be wet frequently with the tincture of myrrh. Where the bone 
has exfoliated and formed an opening into the cavity of the nose 
the opening may be filled with cotton or a plate worn over it by 
which fluids will be prevented from passing into the nose, and 
the voice will be natural. The chief reliance for the cure is in 
constitutional treatment. 

In ulcer of the throat the tincture of myrrh, No. 6, a strong 
decoction of sumac leaves and berries, and tincture of lobelia, 
may be employed as gargles. Breathing the steam from hot 
water a portion of lobelia being thrown in the wat^r occasionally,. 



S90 OBSTRUCTED MEJrSTRUATIOSr. 

will prove beneficial when the disease attacks the mouth throat 
or nose. 

Where the nose is diseased the patient should frequently resort 
to the breathing of steatn through the nostrils, and the parts 
should be syringed occasionally with bayberry or sumac tea ad- 
ding a portion of No. 6 or the simple tincture of myrrh. 

Syphilitic eruptions are in general very readily cured by the 
use of the vapour bath, a course or two of medicine, bathing the 
eruptions with a preparation made by adding sumac berries to 
No. 6, or with the third preparation of lobelia, and then apply 
the stimulating ointment or some kind of salve to protect the 
parts from the air; this last is more particularly needed in case 
of ulceration. 

Where the periosteum of the bone becomes diseased, and therd 
is evidence of the existence of fluid between the periosteum and 
the bone, attended with throbbing pain and a blush upon the 
skin, it should be opened, and the part poulticed until the swell- 
ing and inflammation subside, when a strengthening plaster must 
be applied, and if the parts be slow in healing, syringe the cavity 
with tincture of myrrh. 

In many cases the swelling will fluctuate, proving the exist- 
ence of a fluid, but unaccompanied with pain, and without in- 
flammation or a blush of red upon the skin; here it will be im- 
proper to make an opening into the swelling, but steam the limb 
daily, apply stimulating embrocations, keep the parts warm and 
bandaged, and employ constitutional remedies. 



CHAPTER XVIII. 



SECTION I. 



OBSTRUCTMB MEJ^STRUATIOM 

BerAngement in the function of menstruation may be occa^ 
'Bioned by a variety of causes, the most prominent of which is ex- 
posure to cold and wet during the menstrual period, or imme- 
diately preceding the time of its occurrence. 

This function may be either partially or completely suspended. 
Some females during this period exi)crience pain almost as sc- 



OBSTRUCTED MENSTRUATION. 391 

vere as labour pains, and which continue in some instances seve- 
ral (lays, in others only a few hours. 

When menstruation does not come on at the period of life at 
which it usually does, i\ is termed suppressed menstruation. — 
The symptoms usually attending the complaint, and the treat- 
ment indicated will be found under the head of chlorosis or green 
sickness. 

An excessive flow of the menses depends upon constitutional 
debility or a disordered condition of the system, and the same 
course of treatment that regulates this secretion wlien too profuse, 
may be found equally applicable when this function is partially 
or wholly obstructed. 

Various derangements of the system are observed to follow as 
a consequence of obstructed menstruation, such as violent pain in 
the head, bleeding from the nose, violent fever, delirium, bleed- 
ing from tlie lungs, and violent pain in the side, back or loins. 

Treatment. — Whether the obstruction be partial or complete 
the case will require to be treated upon the same general princi- 
ples. The indications of treatment are to restore tlie natural 
warmth of the body to excite and sustain the capillary circulation, 
to correct the disordered condition of the stomach and bowels, and 
to strengthen the nervous energy which governs tliis and every 
other function of the body. The rem.edies and means to be em- 
ployed to fulfil these important indications, are pure stimulants; 
the vapour bath, emetics, anti-canker medicine, and injections 
to the bowels. These remedies to be applied according to the 
circumstance of the case; when the symptoms are violent the re- 
medies must be applied more liberally, than in slight derange- 
ments. 

There are no other means so effectual in restoi'ing the func- 
tion of menstruation as regular courses of medicine; and the free 
use of injections to the bowels, containing stimulants and lobelia. 
Half a pint of strong pennyroyal tea adding a teaspoonful of No. 
6 and as much green lobelia and bayberry or sumac tea, adding a 
teaspoonful of the third preparation of lobelia; or composition tea 
adding a teaspoonful of green lobelia, may be employed. 

In some instances it is only necessary to soak the feet two or 
three times a day, to use a few injections, drink freely of warm 
pennyroyal tea, and keep covered warmly in bed, with a warm 
brick placed at the feet. 

In other instances the case will demand the frequent repetition 
of a course of medicine, together with the frequently repeated use 
of the other means already mentioned, more particularly the in- 
jections. The functions of the kidneys, bladder and uterus, may 
be more immediately and effectually influenced by means of in- 
jections than by medicine taken into the stomach. 



392 



OBSTeIicTED MENSTRtATlON^. 



When the derangement has become seated, and depends upon 
constitutional debility, the patient should seek the fresh air, use 
moderate exercise, sponge the body with cold salt water in the 
morning, repeating it twice or three times a week, apply fric- 
tion to the surface with a flesh brush or salted towel, and take 
such medicine as the circumstances of the case may demand, ob- 
serving especial care to keep the feet dry. 

The use of tonics are indicated when the derangement has 
been of long standing and the patient weak and relaxed. The 
ladies' spice bitters which contain a portion of gum myrrh and 
unicorn root, may be employed as a general tonic and stimulant 
in such cases. 

In nine cases out of every ten of the cases of obstructed men- 
struation, the derangement is occasioned by exposure of the feet 
to cold and dampness. Standing upon a damp pavement or upon 
wet ground, in thin soled shoes, is very apt to occasion obstruc- 
tions in the system, not always to be removed without consider- 
able difficulty. 



SECTION II. 



TREATMENT OF FLUOR ALBUS, OR WHITES. 



Whbn^ this complaint is attended by general debility, which 
is its most common cause, a permanent cure cannot be antici- 
pated without an improvement in the general health. To effect 
this a course or two of medicine will be required in most in- 
stances, to cleanse the stomach and bowels; after which the ladies' 
spice bitters, or some other form of bitters should be taken be- 
fore meals; and a teacup two-thirds full of bayberry or sumac 
tea adding a teaspoonful of composition powder, or half a tea- 
spoonful of cayenne pepper to the tea every night or morning 
to keep the stomach from becoming foul. This dose will some- 
times vomit but never unless the stomach be disordered, and then 
it will always be beneficial. Haifa pint of a strong decoction 
of equal portions of sumac or witch hazel leaves, and poplar 
bark administered by injection to the bowels every night at bed- 
time and retained until morning will not only improve the con- 
dition of the bowels, but it will also strengthen the uterine or- 
gans. Injections with a female syringe must also be employed. 
In the early stage of the complaint, or when the parts are irrita- 
ble, a simple decoctioi^ of bayberry or sumac may be employed; 



BEE-STINGS. 393 

but where the sensibility of the parts is blunted, stimulants, as 
No. 6, or cayenne must be added to the anti-canker tea, in quan- 
tity sufficient to be felt very sensibly; the injection to be repeat- 
ed several times a day. 

Sponging the body with salt water in the morning, friction to 
the surface, wholesome and nourishing diet, are important means 
to improve the general strength. 

When the complaint is attended with prolapsus uteri, besides 
the means already mentioned, Mr. Betts's abdominal supporter 
or a similar apparatus should be worn. This subject, however, 
will be treated of more fully in a work on Midwifery, which will 
probably be published next year, 1844. 



CHAPTER XIX. 
MISCELLJiJ^EOUS. 

BEE-STINGS. 



When a person is stung by a honey bee, wasp, hornet, yellow- 
jacket, or humble bee, a severe pain is felt in the part soon fol- 
lowed by inflammation, and swelling. It is the poison injected 
into the wound that causes the pain and inflammation. The de- 
sign of the inflammation is to block up the cellular tissue, and 
prevent the poison from spreading. Hence inflammation is ne- 
cessary, to secure the system from injury by the poison. The 
inflammation, however, may extend much further than is neces- 
sary for accomplishing the object for w hich it is instituted, name- 
ly: to protect the parts surrounding the wound from the effects 
of the poison, and prevent its absorption into the system. All 
that is necessary in these cases, in general, is to apply to the 
parts tincture of lobelia, salt and vinegar, or spirits of harts- 
horne, by means of cotton or soft cloths kept wet with some one 
of the above articles. 

If after the above treatment the parts continue to swell very 
much, and look somewhat like a dropsical swelling, the patient 
should be steamed, and have an emetic administered. 

% Y 



NERVOUSNESS.-~WEAK NERVES. 

This question is often put to physicians. Wiiat sliall I do io 
strengthen my nerves? It is not at all times that the proper re- 
medy can be pointed out, without some inquiry into the patient's 
habits, occupation, &c. Thus one of a nervous temperament, may 
by the free use of tobacco, either by chewing, smoking, or snuffing, 
become extremely nervous from its effects. Whilst one will 
use tobacco freely without apparently weakening his nervous 
system, another will have his nerves very much weakened by 
using it even in moderation. 

The use of any of the narcotic poisons, debilitates the nervous 
system. Hence opium eaters are apt to have their nervous sys- 
tem shattered, and consequently they suffer extreme depression 
of mind, except when the brain is under the immediate influence 
of the narcotic, which produces a kind of hallucination of mind, 
bordering sometimes upon mania. The intemperate use of strong 
drink also weakens the nerves, occasioning tremulous motions of 
the hands and sometimes of the whole muscular system. De- 
pressing passions, venereal excesses, too close application to 
study, more especially in confined and unwholesome air; dys- 
pepsia, and in fine whatever weakens the system generally, will 
weaken the nerves; and in persons of nervous temperament, a 
disordered st^e of the nerves frequently forms a most prominent 
symptom, and then the patient is said to be nervous. Attend- 
ing in a family not long since, a female in middle life inquired 
of me if W6 had not a medicine that would strengthen the nerves. 
I perceived that her nerves were extremely weak, and having 
ascertained that she was a great smoker, I told her wiiat I be- 
lieved to be the chief cause of the nervous weakness, which it ap- 
peared had never occurred to her as having such a tendency. — 
Protracted illness, more especially when poisonous drugs are 
used as medicine, is apt to leave the nervous system in a weak 
condition, sometimes continuing for many years. The same 
means that will restore the general health and strengthen diges- 
tion, w ill strengthen the nervous system. If the nerves are weak 
in consequence of a disordered condition of the stomach, the ori- 
ginal cause must be removed before the nerves can be strength- 
ened. 

The use of the cold shower bath, or sponging the body every 
morning with cold salt water; frictions to the surface with the 
flesh brush, salted towel, or horse hair mitts, together with ex- 
ercise in the open air, are important means for invigorating the 
nervous system. 



:polyi'Us of the n-jse. S95 

The use of tlie various narcotics employed in the regular prac- 
tice, as helladona, stramonium, fox-glove, &c. are injurious and 
very v^^^eakening to the nervous system. 

tA/'eTOTies.— Cypripedium humlie, (Thomson's nerve powder) 
scutilaria latrifolia (scull cap) are chiefly employed as nervines 
in the Thomsonian practice. These may be used on many oc- 
casions with much benefit, as a means of promoting sleep and of 
quieting nervous agitation. A collection of acid in the stomach 
frequently occasions wakefulness, and an excited condition of 
the nervous system, in which case a dose of sal^ratus, orbi-car- 
bonate of soda, in luke-warm water, is a good remedy. 

Lobelia, though not a narcotic, exerts a marked influence in 
calming nervous excitement. There is no remedy of equal value 
in quieting fretfulness and wakefulness in infants and children, 
as the tincture of lobelia, given in small doses. Although it may 
Slot produce sleep with as mucli certainty as laudanum, or some 
other preparation of opium, yet the fact of lobelia being free 
from any deleterious quality, gives it the preference to narcotics. 



POLYPUS OF THE NOSE. 

Polypus of tlie nose is seldom observed in others than those of 
scrofulous constitution. It is generally brought on in conse- 
quence of repeated catarrh or cold. 

During the first stage of catarrh, the mucous membrane of 
the nose becomes dry, then a free secretion of thin fluid is pro- 
duced, terminating finally in a thick pus-like secretion. This 
is the natural course of catarrh as it passes to a favourable ter- 
mination. Whereas in scrofulous constitutions the mucous mem- 
brane when diseased by repeated colds, may be too far debilitat- 
ed to establish that kind of inflammatory action necessary to the 
formation of those salutary secretions above mentioned, and in- 
stead of their being a thick yellowish secretion, whicli terminates 
the disease, leaving the parts in a natural condition, a tough, 
semi-transparent substance is formed on some portion of the lin- 
ing membrane of the nostril, wiiich adheres to the parts and in- 
creases in size, until in some instances it fills one side of the 
nostril, and frequently becoracss extended doWn the posterior na- 
ries, so as to be seen and felt in the throat, behind the palate. 
Polypus is composed of albumen, and in time becomes, in some 
degree organized, blood vessels being shot through it from the 
the mucous membrane. 

A substance similar to polypus of the nose is sometimes formed 
on the uvula of the palate, resembling the soft part of an oyster, 



396 PEOLAPSTTS ANI. 

arising from the same cause, though not so generaly confined to 
those of scrofulous constitutions as the former disorder. 

Treatment. — Polypus of the nose in its early stage may in 
many instances be dispersed by black pepper, composition pow- 
der or finely pulverized blood root snuffled freely up the nostril. 
If the polypus be so large as to obstruct the passage of air through 
the nostril, the powder should be blown upon the polypus through 
a quill. 

Constitutional Treatment,— yVhen the general health is much 
deranged constitutional treatment must be instituted to restore 
a more healthy action in the mucous membrane. 

When the uvula becomes affected in the manner above descri- 
bed, having the appearance of the soft part of an oyster, or of a 
blister, gargling the throat frequently with a mixture of black 
pepper and whiskey, pepper sauce, or strong bayberry or sumac 
tea and pepper, will in general effect a cure in the course of a 
few days. 

Polypus of the nose cannot in every instance be removed by the 
means above mentioned, as in many cases nothing short of a sur- 
gical operation will effect its removal. 



CRAMP IN THE LEGS AND FEET. 

Cramp in the feet and calves of the legs, may in numerous 
instances be prevented by the patient rubbing the feet and legs 
up to the knees with the stimulating liniment, and wearing woo- 
len or worsted stockings at night. A bottle of hot water or a 
hot brick placed at the feet on going to bed, will also prove a 
preventive to cramp. 

Most persons who are attacked with cramp at night, are 
forced to jump out of bed before the muscular spasm can be over- 
come. 



PROLAPSUS AN I— PROTRUSION OF THE BOWEL. 

In this complaint a portion of the intestine protrudes from the 
anus. 

Causes. — Constitutional weakness of the parts; the use of pur- 
gative medicine, especially aloes, pills; and violent straining at 
stool, are the principal causes of the complaint. 

Treatment. — The first point to be attended to when prolapsus 



HERNIA. S97 

takes place, is to return the protruded intestine* This is gene- 
rally easily accomplished early after the protrusion of the hovvel 
takes place, by simply pressing upon the parts. In some cases 
it is best to introduce the finger, previously oiled, into the intes- 
tine, and pressing gently upon the parts until the bowel is re- 
turned into its proper place. 

If the parts become much swollen and inflamed, fomentations 
should be employed by causing the patient to sit over a vessel 
containing boiling water, or vinegar and water; or a warm poul- 
tice applied, composed of lobelia powder and elm, and the pa- 
tient nauseated with small portions of lobelia, before any attempt 
is to be made at returning the intestine. If vomiting should 
occur from the small doses of lobelia, pressure must be made 
upon the protruded bowel at the time. 

The means to be employed for strengthening the bowel are 
injections of a strong decoction of sumac or witch hazle leaves, 
and retained in the bowels several hours, and this repeated dai- 
ly. An injection of the kind above mentioned, administered at 
bed time, may in general be retained until morning. 

In many cases the intestine does not protrude except when the 
bowels are moved. If the prolapsus be liable to occur at other 
times, a tight bandage or a truss made expressly for this com- 
plaint must be worn until the parts become strengthened. 

If the general health be deranged, constitutional treatment 
will be required. Washing the body in cold salt water in the 
morning will prove beneficial in invigorating the system. 

*' In infants a fresh protrusion of the rectum may sometimes 
be prevented by making them set on a high close stool, with tlieir 
feet hanging freely down. Every thing tending to produce 
either diarrhoea or costiveness should be avoided." — Castles^ 
Manual of Surgery, 



HERNIA, OR RUPTURE. 



Hernia in the great majority of instances commences about 
the groin, forming at first a small tumour, but, if neglected, 
the protruded intestine is apt to descend gradually along the 
course of the spermatic chord, and sometimes forms a large tu- 
mour in the scrotum. 

Causes. — The usual exciting causes of hernia are violent 
sneezing, heavy lifting, and hard straining. 

In most instances the protruded intestine forming the tumour, 
is readily returned into the cavity of the abdomen by slight pres- 
sure upon it. This is called reducible hernia. 



398 



STRANGUtATBB H'EEIS-IA- 



In some cases adhesions take place, preventing the return of 
the tumour into the abdomen, forming irreducible hernia. 

Occasionally the protruded intestine becomes strangulated in 
consequence of a stricture at the upper part, or neck of the tu- 
mour, constituting a most formidable and dangerous form of dis- 
ease. From estimates that have been made, it would appear 
that one of every ten or twelve of the individuals in the commu- 
nity, are effected with hernia, or rupture, and still strangu- 
lated hernia is of rare occurrence. The strangulation may be 
either partial or complete; and a patient may experience severe 
pain in the parts without there being any stricture. It is assert- 
ed by experienced surgeons that strangulation is most liable to 
occur where the hernia is very small. 

Treatment— In the treatment of reducible hernia, the first 
point is to return the protruded intestine into the cavity of the 
abdomen, and then apply an appropriate truss. By attending 
to the rupture wlien first discovered, and applying a truss, a per- 
manent cure will in many instances be effected. The truss must 
be worn constantly except when the person is in bed, and always 
be put on again before rising from it. During an effort to 
laugh or sneeze, the hand should be pressed against the parts, 
unless supported by a truss. 

Of the various kinds of trusses introdnced into use, there are 
probably none superior to Dr. Chase's, of Philadelphia. 

In simple irreducible liernia the tumour should be supported by 
a bag, to prevent its further enlargement. 



STRANGULATED HERNIA. 



When berniss becomes strangulated, violent pain is experi^ 
€nced in the part and throughout the belly, attended with sick- 
ness and vomiting, and more or less fever. If the stricture con- 
tinue without being relieved, the most distressing symptoms 
ensue. The patient continues to retch and vomit and the con- 
tents of the bowels down to the stricture are sometimes thrown 
up; the extremities are cold; the pulse small, quick and hard.'^ 
'* After a time hiccough comes on, the pulse is hardly percepti- 
ble, respiration weak, and the whole body covered with a cold 
clammy sweat. Mortification now takes place, beginning in tlie 
protruded viscera and extending to tlie neighbouring parts. 
The patient suddenly becomes easy, the swelling of the belly 
subsides, and tlie tumour of the part diminishes, and the skin 
covering it sometimes changes its natural colour for a livid 
hue." By pressing t!ie tumour with the fingers, a crackling 
or crepitus will be perceived, as tliough bubbles of air were 



STBANGTJLATED HERNIA. 399 

bursting under the pressure of the fingers. ^'This crepitus is 
the sure indication of gangrenous mischief within. In this state 
it goes up spontaneously, or is returned with the smallest degree 
of pressure; a discharge is made by stool, and the patient fan- 
cies himself better. This feeling, however, is of short duration, 
hiccough and the cold sweats increase, convulsive symptoms 
come on and the patient soon expires." 

Treatment of Strangulated Hernia. — The use of the vapour 
or warm water bath, and relaxing the system fully by giving 
the patient freely of lobelia, and administering it also by injec- 
tion and retained, constitutes the treatment most likely to over- 
come the stricture. 

After the patient has been in a vapour or w arm water bath, he 
should be wrap[>ed in a blanket, and kept w arm in bed provided 
perspiration continue. If the skin become dry and the patient 
be oppressed with heat, the surface may be bathed with spirits 
or vinegar. 

The most important means for the cure of strangulated her- 
nia is the use of lobelia injections. They may be prepared by 
adding lobelia powder to simple warm water. The brown 
emetic is to be preferred, a teaspoonful or even a tablespoonful of 
which may be administered at a time and retained. When the 
system becomes relaxed, an attempt should be made to return the 
protruded gut into the cavity of the abdomen, not by simple pres- 
sure upon the tumour, but by placing a hand at each side of the 
tumour, and as gentle pressure is made by the palms of the hands 
the tumour should be drawn backwards, by w hich the contents 
of the intestine will be more likely to return into the cavity of 
the abdomen. Another method is to grasp the tumour with one 
hand, making moderate pressure, and with the finger of the other 
hand, endeavour to push small portions of the intestine through 
the stricture. Tiiis should not be attempted, however, until the 
system has become more or less relaxed by the use of lobelia 
given freely, and administered by injections; together with the 
application of the steam or w arm water bath. 

A patient who has a strangulated hernia should keep the body 
bent forwards, and the knees drawn towards the belly. The po- 
sition generally to be preferred, is on the back with the hips and 
shoulders raised, and the thighs drawn up. 

When the above treatment fails of removing the stricture, af- 
ter being perseveringly employed, the last resort is an operation. 
This, however, will require a surgeon. Although few recover 
after an operation, still it may save life in some cases. The 
operation itself is not severe, nor dangerous, but it is rarely per- 
formed until mortification is about to take place. 



COURSE OF MEDICINE. 

The following process constitutes a Tliomsonian course of 
medicine. 

1st. A steam or vapour bath. The patient taking during the 
operation a dose of composition or pepper tea. 

2d. An emetic, prepared and administered according to the 
directions hereafter given. 

3d. An injection to operate upon the bowels. In most cases 
it is better to administer an injection at the commencement, be- 
fore the vapour bath, and repeat it after the emetic operates. 

4th. After tlie operation of the emetic, the vapour bath is again 
applied, to restore a natural warmth to the system, or as Dr. 
Thomson expresses it, "to set the wheels of life in proper ac- 
tion." When the patient has remained a sufficient length of 
time in the bath he must be showered with cold water, or spon- 
ged with whiskey or vinegar, rubbed dry, and in most instances 
it is best to bathe the skin with salt and vine8;ar, or No. 6. 

5th. Light nourishment is to be given aft^r the emetic ope- 
rates, either before or after the last bath, as the inclination of 
the patient may dictate. Milk porridge is generally given as 
nourishment after a course of medicine, and when the patient 
inclines to take it during the operation, it may be given, as it 
will assist the operation of the emetic. In sudden attacks of dis- 
ease, however, as in fevers, pleurisy, &c. crust cuifee, elm, gruel, 
barley water, or gum arabic water will be more suitable 

The above process, termed a course of medicine, first insti- 
tuted by Samuel Thomson, is the most effectual, consistent and 
philosophical plan of treatment ever devised for the cure of dis- 
ease. By courses of medicine, together with the usual interme- 
mediate treatment, disease may be cured that has resisted every 
other plan of treatment; and even though it fail of effecting a 
cure, still the treatment will not injure the constitution — the de- 
clarations of medical men to the contrary notwithstanding. The 
medical profession manifest a degree of prejudice against the 
Thomsonian practice that is wholly inexcusable. As guardians 
of the health and lives of the community, they should know bet- 
ter than to make the outlandish, false and absurd assertions 
which many of them do in relation to the Thomsonian practice. 

2 Z ^# 



GENERAL DIRECTIONS FOR ADMINISTERING A 
COURSE OF MEDICINE. 



1st. The Vapour Bath — Various methods are employed in the 
application of the vapour or steam bath; the usual plan, however, 
is to place the patient upon a tight bottomed chair, throwing a 
quilt over him, leaving the liead uncovered; a flat bottom- 
ed bason or dripping pan is to be placed under the chair, a quart 
of hot water poured in, and put into it a red hot brick or stone. 
If the brick be entirely red hot it should be set in sidewise at 
first, or the steam may be too warm for the patient to bear; 
in a few minutes the brick may be placed with the flat side down. 
Three bricks will be sufiicient provided they are thoroughly dry 
and red hot on one side. If the steam be too hot the quilt may 
be raised from the floor so as to admit the cold air, and when 
th€ patient feels oppressed with the heat, the face and head must 
be frequently wet with vinegar and water or whiskey, and occa- 
sionally the body of the patient should washed or sponged with 
cold or tepid water; during the latter part, or at the close of the 
steaming, a shower bath must be used, or the patient washed 
in cold water or spirits. 

The feet may be more eff*ectually steamed by placing a stool 
upon the chair, the patient sitting upon the stool and resting the 
heels upon the edge of the seat of the chair. 

A small tin boiler and pipe for conveying steam either into a 
steam closet, or under a chair, is more convenient than hot 
bricks, and the steam can be more easily regulated than when 
bricks are used. 

Steaming in feed.— When a patient is too weak to sit up, the 
steam may be applied to the patient in bed by means of hot bricks 
wrapt in damp cloths, or by placing a frame work made of three 
barrel hoops, with the ends cut off and tied to two strips of plas- 
tering lath, or something of about the same length. This frame 
is placed over the patient and a cover spread on, leaving the 
head uncovered. The steam to be conveyed through a pipe 
from a boiler, or it may be generated by putting basins under 
the cover containing a little hot water, and placing hot bricks 
therein. Patients who are too Vi^eak to sit up, will often bear the 
steam applied in this way an hour or even more by using the 
precaution to wet the face frequently, and t]je body occasionally 
with \yhiskey and water or vinegar. 

The steam box or closet possesses many advantages over 
the usual mode of steaming on a chair, the greatest of which 
is the facility of applying the shower bath. This, however, may 



COURSE OF MEDICINE. 403 

be done very readily without the steam box. Open tlie cover at 
the neck and pour a pitcher of cold water upon the head of th@ 
patient, having an old quilt or carpet placed under the chair 
to catch the water. 

The patient may continue in the bath from fifteen minutes to 
three quarters of an hour, or even longer, as the circumstances 
of the case may require. Sometimes patients feel faint vvliile in 
the bath, which may arise simply from sitting upright, or it may 
depend upon a disordered condition of the stomach. A dash of 
water in the face, fresh air, and wetting the head with vinegar, 
will overcome faintness and oppression. Some patients will 
swoon away on sitting up a few minutes whether they be in a 
steam bath or not. There is no danger to he apprehended from 
fainting, except in very sunken states of the system, as in low 
cases of typhus fever, &c. All tliat is required when fainting 
occurs, is to lay the head as low or even lower than the body, 
sprinkle some cold water in the face, and apply hartshorn, or 
some smelling salts to the nose. Of the thousands of vapour 
baths that have been administered under my observation, I have 
never seen but three patients faint during the operation. 

The Emetic. — There are many modes of preparing an emetic. 
For ordinary cases the following will he found effectual. 

A teaspoonful of the third preparation of lobelia: 
A teaspoonful of green or brown lobelia: 
A large teaspoonful of sugar: 
Rub these well togetlier in a teacup, and then pour on a tea- 
cup two-thirds full of strong hayberry or No. 3 tea, nearly 
scalding hot: stir it occasionally and take it luke-w^arm. 

A similar dose is to be repeated in the course of twenty mi- 
nutes or half an hour. It is seldom necessary to take more than 
two doses, still more maybe given if required. I have on many 
occasions given two and three ounces of lobelia in administering 
a course of medicine. 

In all cases of seated disease where the stomach is weak and 
the system relaxed, the emetic should be combined with the more 
active stimulants, such as the formula above mentioned, ad- 
ding freely of No. 6, or pepper to the emetic. In low cases of 
protracted fevers there is no better form of emetic than the liquid 
of the third preparation of lobelia in strong bayberry or No. 3 
tea. 

Another Method of Preparing the Emetic. — Take a large heap- 
ing tablespoonful of bayberry or No. 3 powder and an even 
teaspoonful of cayenne, pour on half a pint of boiling water; and 
then add a teaspoonful of nerve powder, when it settles pour or 



404 



COURSE OP MEDIClJfE. 



straiii off tlie tea, and whilst moderately hot add four teaspooHS- 
ful of green or hrown lobelia powder, and sweeten. This may 
be taken at once or at two or three times at intervals of fifteen 
or twenty minutes. The stronger the bayberry tea the more 
easily and effectually will the emetic operate. 

Another Flan of Preparing the Emetic. — Take a teaspoonful of 
lobelia powder, half a teaspoonful of nerve powder, and two large 
teagpoonsful of No. 6. Pour on a tea cup two-thirds full of 
strong bayberry or composition tea, sweeten and take warm. — 
The dose to be repeated three or four times atinterv8J|J of fifteen 
or twenty minutes. 

And again, the lobelia powder may be mixed in strong com- 
position tea, sweetened, and taken in tlie usual doses. This last 
is the way in which emetics are usually prepared for children. 

After the emetic is given the patient need not take much drink 
until the emetic operates. It is a practice with too many nurses 
to force the patient to drink a cup of medicine every few^ minutes 
during the operation of a course of medicine. It is much better 
to allow the emetic to remain on the stomach as long as it will, 
or at least an hour or two. Where it is desired to make the 
emetic operate it may generally be effected by giving the patient 
a tlose of pepper tea or a teaspoonful of the super-carbonate of 
soda, or half a teaspoonful of sal^eratus dissolved in a tumbler 
half full of loke-warm water. In cases of great debility the pa- 
tient should take occasionally during the course of medicine, a 
dose of pepper tea or of composition and No. 6; and after vomit- 
ing, milk porridge, chicken tea, or some other kind of nour- 
ishment, seasoned with pepper. 

3d, The Injection. — In most cases it is better that an injection 
be administered in tlie commencement of the course, before the 
vapour bath is administered, and another after the operation of 
the emetic. 

The injection may be prepared in the same way as an emetic. 
A very common form for injections is half a pint of cojnposition 
tea adding a teaspoonful of nerve powder to the tea whilst hot, 
and when hike wai'm a teaspoonful of lobelia powder and as 
much No. 6. This answers for common cases. Where there is 
canker in the bowels, and in case of dysentery, cholera morbus, 
&c. the bayberry or No. 3 tea should be used, adding the liquid 
of the third preparation of lobelia, or two or three teaspoonsful of 
No. 6, and a teaspoonful of green lobelia. 

If the bowels be mucli disordered, injections will in general 
occasion more or less pain and distress for a short time, tlie pa- 
tient, nevertheless experiences much relief from the operation. 
An injection containing lobelia if retained in the bowels will 



COURSE OF MEDICISTE* 405 

often cause sickness at the stomach and vomiting, and effectual^ 
ly relax the system. Recent attacks of disease have in many in- 
stances heen broken up by such an operation. As a general rule 
I have observed that patients experience the most benefit from in- 
jections that occasion the most distress and pain. Lobelia pos- 
sesses a property of arousing the sensibility of the stomach and 
bowels, so that if they are diseased it causes the patient to feel 
the disease. 

4tJu The Second Vapour Bath.— -The proper time for adminis- 
tering the last steam bath in a course of medicine as a general 
rule is, when the patient ceases to sweat, or becomes restless 
after the operation of tlie emetic. If the patient continue to retch 
and vomit a long time, tliere is nothing so effectual in settling 
the stomach as a steaming. When the steaming has been con- 
tinued long enough, the patient must be showered with cold 
water or washed with vinegar^ or spirits, rubbed dry, and kept 
warm. It is beneficial in many cases to bathe the surface with 
No. 6, pepper sauce, or stimulating liniment, after the last 
bath, and when the patient is rubbed dry. This is more especi- 
ally needed where the skin is in a relaxed condition, as in chronic 
rheumatism, bronchitis, asthma, consumption, &c. Sometimes 
the skin is extremely sensitive to stimulants, and if applied too 
freely will occasion a severe burning sensatian in the skin, which 
may continue several hours. 

jPooiI.— Some persons on reading Dr. Thomson's work, un- 
derstand him to say that patients after a course of medicine may 
take almost every kind of food. It is those cases where the ap- 
petite and digestion are restored that Dr. Thomson alludes to 
when he speaks of giving almost any kind of food that the appe- 
tite may crave. In most cases of disease the digestive powers 
are too feeble to digest any but the lightest kinds of food, such 
as barley water, crust coifee, arrow root gruel, gum arabic 
water. Even milk porridge which is generally given after a 
course of medicine is not adapted to cases of fevers, severe pleu- 
risy, inflammation of the lungs, and in the early stages of al- 
most every sudden attack of disease. It is far better that a pa- 
tient in the early stage of a severe attack of disease, abstain from 
food altogether than to take such as will oppress the stomach. 

From three to six hours is in general required for a foil course 
of medicine; and except in urgent cases, it is better to allow the 
emetic to remain on the stomach an hour or two, or at least t& 
avoid forcing t!ie patient to drink largely of teas soon after the 
emetic is taken. 

A Short or Fartial Course of Medicine, — In very many in- 



406 COtlRSE OF MEDICINE. 

stances a full course of medicine is not required; all that is ne- 
cessary is to restore the natural warmth of the body, and then 
to give an emetic, dispensing with the second bath. 

Emetics without Steaming. — In sudden and violent attacks of 
disease, as in croup, fits, colic, sick head-ache, cholera morbus, 
and in fine all sudden attacks of disease, an emetic may be given 
"without the previous administration of a vapour bath, or any 
other preparation. 

Hot bricks wrapped in damp cloths, placed around a patient, 
may take, in many cases, the place of the vapour bath. Thus 
in cases of low fevers, as they are termed, it often becomes ne- 
cessary to vomit a patient every day when he is too weak to sit 
up. In rheumatism, when the patient cannot be moved witiiout 
occasioning severe pain, it may be better, especially in cold 
weather, to give emetics without moving the patient from the 
bed. If the weather be warm, however, it will, in the majority 
of instances, be better to have the patient regularly steamed and 
showered. 

Steaming when the patient is too weak to sit np. — When a pa- 
tient is unable to sit up, the vapour bath may he applied on a 
couch or mattress, by means of a frame made of three barrel 
hoops and two or three plastering laths or something of about 
the same length and size. Eight or ten inches of each end of 
the hoops must be cut off and the laths tied to the hoops so as to 
form a frame which must be placed over the patient, and a quilt 
thrown over, leaving the patient's head uncovered. The steam 
to be conveyed under the cover through a pipe, or by placing a 
red hot brick in a basin containing a small quantity of water un~ 
1 1 der the frame. In the place of the frame above mentioned, the 

patient may have the bath administered on a settee or sofa. Pa- 
tients who are too weak to sit up will bear steaming in this way 
an hour or more at a time. The face and breast should be bath- 
ed occasionally with vinegar and water, or spirits and water, 
the patient taking a small dose of stimulating tea several times 
during the operation. 

Preparing the Patient for a Course of Medicine. — In sudden at- 
tacks and in all cases of acute disease a course of medicine may 
be given as before stated without any preparatory medicine; 
whereas, in chronic complaints, as in consumption, deep seated 
dyspepsia and in cases where the system is in a cold and torpid 
condition, a course of medicine will prove more effectud by the 
patient taking composition several times a day and three or four 
compound lobelia pills at night, and continuing the use of these? 
medicines several days before the course is administered. 



(DdTJRSE OF MEDICINE. 40f 

J^ejjeating the Course of Medicine. — In the first stages of disease 
and more especially if the attack be violent the course of medi- 
cine, or at least a partial course may be repeated daily until the 
symptoms abate. In small pox, measles, and scarlet fever, the 
disease will run its course, and all tliat we can anticipate from 
the operation of medicine in these cases is to relieve the symp- 
toms, and aid the constitution to work off the disease in the 
way which nature or the God of nature has established. In 
chronic complaints as in long standing dyspepsia, consumption, 
chronic gout, and rheumatism and whenever there is absence of 
fever, a course of medicine will seldom become necessary oftener 
than once in two or three weeks. In fine there are many cases 
of seated disease in which more reliance is to be placed upon 
fresh air, a change of residence, travelling, sea bathing, and a 
strict attention to diet and regimen, than upon medicine, 

Remarks concerning the various symptoms attending the operation 
of a Course of Medicine, 

I have heard persons say that they never felt better than when 
going througli a course of medicine, excepting the few minutes 
when the sickness and vomiting came on; and then again under 
a different condition of the system, patients will experience great 
pain and distress from the effects of the medicine. The tenden- 
cy of the course of medicine is to arouse the sensibility and to 
assist the efforts of nature to overcome obstructions, cast off mor- 
bid matter from the stomach, and to restore a natural action 
throughout the system; and hence the more the system is dis- 
eased the more distressed the patient will be when he is made to 
feel his real condition. 

At one time a patient may vomit by merely taking a dose of 
composition tea, whilst at another, when the stomach is in a dif- 
ferent condition, lialf a dozen doses of composition will not oc- 
casion the slightest sickness. Thus a patient with a very foul 
stomach, will become very sick from taking a dose of composi- 
tion or of bayberry and pepper during the first steaming in a 
course of medicine, and after the operation of an emetic and the 
stomach becomes settled, a pint of composition may be taken 
without causing vomiting. It often happens, however, that the 
stomach will not be settled until after the last bath, the patient 
vomiting freely on having his system warmed by the steam, and 
by taking stimulants; after which the stomach will not be dis- 
turbed by these medicines, even though tJiey be taken freely. 

A vapour bath when administered previously to an emetic, or 
when the emetic has not operated effectually, may occasion sick- 
ness at the stomach, and cause the patient to feel weak and fainty 
for a time, but will increase the strength when the stomach is not 



408 



COURSE OF MEDICINE. 



foul. I have on many occasions observed a patient on taking a 
course of medicine to be much stronger after the last steam, who 
had felt weak and relaxed from the first in consequence of the 
disordered state of the stomach. Patients sometimes become 
sick during the first part of the steaming, and feel as though 
"they cannot sit up, or bear it any longer, but by throwing cold 
water in the face and allowing fresh air to come to the patient, 
the sickness will pass off in a short time, and when perspiration 
becomes free the patient will experience no difficulty in sitting 
in the bath the usual time required for the operation. 

When the stomach is cold and contains acid, a dose of pepper 
or composition tea is apt to cause pain in the stomach, more 
especially during the first steaming in a course of medicine. 
In such cases the pain is relieved when the patient belches wind 
or gas from the stomach. Some No. 6 in hot water, taken as 
hot as the patient can bear it, will cause the gas to be sent up and 
the patient is thus relieved. Essence of pepper mint, lavender, or 
any thing that is good to expel wind from the stomach may be 
employed. 

The operation of an emetic, which in certain conditions of the 
system is attended with scarcely any unpleasant feelings, under 
other circumstances, for instance, where there is great derange- 
ment in the stomach and bowels will be accompanied by distress- 
ing sickness and pain. The relaxation and sickness sometimes 
produced under the influence of lobelia, is said to be very much 
like extreme sea-sickness. Probably no case of death has ever 
been occasioned by sea-sickness alone, although it sometimes 
lasts many days or even weeks, the patient continuing to retch 
and vomit almost incessantly. 



The alarming symptoms as ih^j are termed, seldom or never 
occur to any considerable degree under the operation of a course 
of medicine, except where disease is deeply seated, or in patients 
of a peculiarly nervous temperament. Much, however, depends 
upon the form of the emetic. Thus the lobelia seed given with- 
out much stimulus will occasion more or less relaxation of the 
system in almost every instance; still the same form and quan- 
tity of the medicine will produce great diversity of symptoms in 
different conditions of the stomach; and in persons of different 
temperament. I have observed half a teaspoonfui of the brown 
emetic (lobelia seed) to bring on what are called alarming symp- 
ti>ms, in patients %vho during a preceding course of medicine had 
taken five teaspoonsful witliout producing such symptoms. The 
following case will serve as an illustration of what I have assert- 
ed. An elderly man by the name of Smedley, who had seated 
consumption, had several thorough courses of medicine adminis- 
tered to him without occasioning other symptoms than those 



COURSE OF MEDICI!?E. 409 

which usually attend the operation, until the nintli course, when 
t!ie first dose of emetic, which was a small one, brought on the 
alarming symptoms, so called, that continued more than fourteen 
hours, when he vomited freely, and soon after fell asleep, and 
when he awoke he had scarcely any recollection of the strange 
condition which he had been in during the continuance of the 
alarming symptoms. This operation appeared to benefit him 
more than ail the previous treatment. 

In many instances patients will experience pain in the stomach 
or bowels, soon after taking the emetic, but which generally 
continues but a short time, yet sometimes for several hours. 
In other cases, and more especially when disease is deeply root- 
ed in the system, the patient whilst under the influence of a course 
of medicine will exhibit symptoms, well calculated to alarm those 
who have not witnessed them before or who do not know that 
there is no danger to be apprehended. Some will complain of 
distress in the bowels, throw themselves about t!)e bed, utter 
broken sentences, speak in a hurried and unconnected manner, 
sob and breathe very irregularly, get out of bed, make frequent 
efforts at stool, and be constantly changing position. Some- 
times the system will become completely relaxed, and still the 
pulse have nearly its natural strength; the countenance will be 
pale, the skin cool, the breathing irregular, and the patient 
thirsty. During the continuance of these symptoms, there is 
great commotion in the stomach and bowels as though the vital 
forces were concentrated there to root out disease. I am fully con- 
vinced from a great deal of observation that during alarming 
symptoms the nervous influence is chiefly concentrated in the 
great sympathetic system of nerves which govern the functions 
of the internal organs, by which a new action is established and 
disease removed. When a patient is very much relaxed under 
the influence of the emetic, his face, breast and hands should be 
bathed with vinegar or whiskey, and take occasionally some 
stimulants, either pepper or composition tea. No. 6 in warm 
water, or milk porridge well seasoned w ith pepper. If the patient 
crave cold water it may be allowed to be taken in small quanti- 
ties; still pennyroyal or other simple herb tea is more suitable. 

In a great number of instances where patients under my treat- 
ment have had tlie alarming symptoms during the operation of 
a course of medicine, very little perceivable eftect was produced 
by any thing that was done. The medicine previously given 
having takeji effect, it seemed to require a certain time for its 
full operation upon the system, varying in duration, however, 
according to the circumstances of the case. In some instances 
the alarming symptoms will pass off in the course of an hour 
from the time of their commencement, whilst in others they may 
continue six or eight hours, or even much longer. I once had a 

3 A 



410 



COURSE or MEDICINE. 



patient, who continued with the alarming symptoms thirty-six 
hours, after which she slept several hours and the next day was 
better than she had been for several preceding months, and de- 
clared that she would not object to going through a simi- 
lar operation. On the following week another course was ad- 
ministered to this patient, distressing symptoms came on such as 
occurred during the preceding operation, and continued over 
twenty-four hours. With a view to shorten the duration of the 
course, I at the suggestion of Dr. John Smith commenced giving 
the patient the third preparation of lobelia in tablespoonful doses 
repeating the dose every twenty minutes until twelve tablespoons- 
ful were given, and although this evidently assisted the opera- 
tion of the medicine, still the alarming symptoms continued 
about thirty hours. This case was one which scarcely promised 
even a hope of recovery, yet after undergoing three such opera- 
tions her health greatly improved, to the astonishment of all who 
knew her case. 

The following symptoms will often be observed during the 
operation of a thorough and etBcient course of medicine, in cases 
where the disease is deeply seated, and especially when it is 
about giving way, to wit: soon after the emetic is taken the 
patient complains of pain or distress in the stomach, which soon 
extends to the bowels; he is continually changing his position; 
rubs his stomach and bowels and complains very much of dis- 
tressing feelings. The breathing becomes irregular, respiration 
being sudden, somewhat like the sobbing of a child. The distress- 
ing feelings in the bowels subside, but the patient remains re- 
laxed, the skin colder than natural and contracted; the mucous 
membrane of the nose is dry, inducing the patient to pick or 
rub his nose frequently; the tongue and mouth are dry, attended 
with more or less thirst. The patient makes efforts to get out 
of bed, frequently feels like having a motion from his bowels; 
talks in an unconnected manner, and sometimes lies completely 
relaxed, apparently too weak to raise his hands, and the coun- 
tenance is pale and contracted. After the lapse of a few, 
but usually in the course of four hours, and frequently much 
longer, the patient vomits freely, after which he goes to sleep, 
his skin becomes moist, he sleeps sweetly, and when he awakes 
feels much better than he did previously to the operation. 

Thomsonians are frequently applied to in desperate cases, 
where it is impossible to determine whether the disease is curable 
or not, and notwithstanding the grave charges so frequently 
against the Thomsonian practice when it fails of removing dis- 
ease, still a trial should be made, so long as the circumstances 
of the case furnish grounds for a reasonable hope of success. 
Courses of medicine are sometimes administered with the view 
only of affording relief to the patient, the disease being evidently 



COURSE OF MEDICINE. 411 

incurable; and yet it would seem that a portion of the commu- 
nity, and some who ought to know better, attribute every death 
that occurs where Thomsonian treatment is employed, to want of 
skill in those who have charge of the case. Among the great 
mass of desperate cases that come under Thomsonian treatment 
deaths will, in the \ery nature of things, occasionally happen 
unexpectedly and under unfavourable circumstances. In the 
early period of my practice I was called to attend the wife of 
Samuel Wheeler, of Wilmington, Del., and found Mrs. W\ as I 
then thought in a condition to be benefitted hj a course of medi- 
cine, and had determined on having one administered. A dose 
of composition was prepared, but before it was sufficiently cool 
to be taken, she expired. Had I arrived two hours earlier than 
I did, doubtless Mrs. W^. would )iave died whilst under the oper- 
ation of a course of medicine, and although the medicine might 
have prolonged the life of the patient a short period, still she 
could not have survived many hours longer than she did, as mor- 
tification had already taken place. Courses of medicine doubt- 
less have been and will again be administered to patients on the 
very verge of dissolution, creating not only an unfavourable 
impression in the neighbourhood where it happens, but a highly 
coloured and distorted occount of the case is carried to various 
parts of the country. The general good success, however, at- 
tending the Thomsonian practice, affords sufficient evidence to 
establish the belief that it is based upon correct principles, and 
that this system furnishes the means which the constitution re- 
quires to overcome disease; for although it does, and must neces- 
sarily fail sometimes of effecting cures, yet what evidence have 
we that it will not prove successful when properly applied, in all 
cases that are curable by means of medicine. 

Most patients experience an unusual degree of weakness and 
general distressed feeling aboutthetime a disease is giving way; 
the patient feeling discouraged, under the impression that the 
course of medicine, or other treatment is too hard for his consti- 
tution. In every case of deeply seated disease, that I have treat- 
ed and a cure has been effected, the patient was discouraged about 
the time that the disease was giving way: the system being re- 
laxed, attended witli loss of appetite, disgust for medicine, and 
frequent pain and distress in the bowels. 

•Of the removal of morbid secretions or false membrane from the 
coats of the stomach and bowels. 

In disease of every form and variety the stomach and bowels 
are more or loss coated with thickened tenacious secretions, 
which are often thrown up by vomiting in the form of little 
flakes of a skinny like substance; and passed off from the bowels 



412 



BLOOD-LETTING. 



sometimes in small pieces and at other times in strips a foot or 
more in lengtli. The first that I ever saw of this false mem- 
brane was in the summer of 34. I had administered a course of 
medicine to a patient, and accidentally discovered that a large 
quantity of a skinny like substance had passed from his bowels. 
This fact struck my attention at the time, and from that period 
to the present time 43, I have found it to be universally present 
in all cases of disease, at least with very few exceptions, and as 
a general rule disease begins to yield as this false membrane 
passes away. There is no plan of treatment that can be adopted 
that would prove as effectual in removing this coating of morbid 
matter from the stomach and bowels, as courses of medicine and 
a free use of cayenne pepper and bayberry. Avoid cathartics as 
they occasion still greater derangement in the secretions, and if 
given freely to one in perfect health they will be very likely to 
occasion a false membrane to be foi*med on the mucous membrane 
of the bowels. The indications of treatment are — to restore the 
secretions by courses of medicine, or by the use of pure stimu- 
lants and the vapour bath, together with the use of bayberry or 
other of the anti-canker medicines. 

An essay from the pen of the late Dr. Thamson of Edinburgh 
ap])eared in a medical journal published in the year of 1836 in 
which the writer gives a considerable number of cases in which 
a false membrane was discharged from tlie bowels in different 
diseases, and patients affected with clironic diseases, were re- 
stored to health after the passing off of the false membrane from 
the bowels, which sometimes closely resembled an intestine. — ■ 
Tlie passing away of this substance in the cases reported does 
not seem to have been brought about by medical treatment but 
rather by the efforts of nature, and generally after a sudden at- 
tack of fever, colic, or other acute attack of disease. 

This subject though of great importance in a medical point of 
view, has not to my knowledge ever engaged the attention of the 
medical profession in this country. Dr. S. Thomson in using the 
term *^ canker^' has allusion to morbid secretions coating the 
stomach and bowels, and through his discoveries we are furnish- 
ed with the knowledge of the best means to effect their removal. 



BLOOD-LETTING. 



Takixg away blood does not remove tlie cause of disease but, 
on the contrai'y its direct tendency is to prostrate the curative 



BLOOD-LSTTIJfG. 41$ 

actions of the constitution, and although patients may experi- 
ence relief from pain, by the abstraction of blood, still the cure 
may be very much retarded by it and it may cause the death of the 
patient. A person in health may lose a large quantity of blood 
without experiencing other inconveniancethan debility, for when 
digestion is carried on with considerable vigor tlie blood is soon 
replaced. But in disease where the digestive powers are greatly 
impaired or suspended, the loss of blood cannot be readily sup- 
plied, and if the bleeding be carried to a great extent the patient 
will be very apt to remain a longtime in feeble health, and very 
probably be left with some deeply seated chronic disease, dyspep- 
sia, liver complaint, consumption, or dropsy. 

The blood furnishes the organs w ith power to carry on their 
functions, and to resist the causes of disease; and in proportion 
to the quantity of blood taken from the body will the system lose 
its power of resisting disease. An undue accumulation of blood 
in a part is always attended by a deficiency of it in other parts, 
and we have sufficient evidence to warrant the assertion, that 
the Thomsonian practice, if properly applied, will prove more 
effectual in equalizing the circulation of the blood than any other 
plan of treatment that has ever been pursued — the patient still 
retains his blood to aid in restoring his lost health. 

A patient having a good constitution may, in the early stage 
of disease, be bled profusely, and recover his health, not in con- 
sequence of the loss of blood, however, but in spite of the bleed- 
ing; whereas in a later period of disease, where the vital powers 
of the patient are much enfeebled or in very young or very aged 
persons, the loss of even a few ounces of blood would be very 
liable to be followed by extreme prostration, and probably cause 
the death of the patient. That blood-letting removes pain, les- 
sens fever, or relieves the head, is no evidence that it cures dis- 
ease, for these very symptoms, pain and fever, are in general, 
the consequence of the vital powers resisting disease; and what 
can be more absurd than to break down the living power, in or- 
der to relieve pain. But blood-letting will not always relieve 
pain, except tlie patient be brought so low by it as to destroy his 
sensibility; and very often in cases where pain is relieved by a 
€opious bleeding, it will return again in a more aggravated 
form, the constitution having to struggle not only against the 
cause of disease, but also against the effects of the loss of blood. 

Formerly it was the universal opinion that blood-letting was 
necessary in cases of severe bruises, to prevent the occurrence of 
inflammation. Experience and observation, however, does not 
confirm the propriety or necessity of this practice. Look on the 
other hand and we will find that the most expei'ienced sui'geons 
admit the danger of drawing blood in cases of severe injuries, 
especially immediately after an injury, before the system reacts. 



414 



EiOOD-XETTIFG. 



Dr. M'CIellan in lecturing upon the subject of severe injuries 
and the prevailing practice of bleeding patients immediately af- 
ter their occurrence, said : ^ ' By far the greater portion of deaths 
which occur in these cases, are occasioned by too frequent and 
continued bleedings before the system has had time to recover 
from the shock. Thousands and tens of thousands of lives have 
been destroyed by this practice." 

A physician of the old sciiool told me not long since, that for- 
merly he thought he must bleed whenever he saw evidences of 
inflammation, but that within the last few years he had almost 
abandoned this practice of bleeding, and found that his patients 
now recovered more speedily and effectually even from inflam- 
matory diseases than when he resorted to its use. The fact 
is, in the regular practice there are no general established prin- 
ciples for treating disease; almost every physician having his 
favourite hobby. Thus one will prescribe anodynes under the 
same circumstances that another would employ bleeding, while 
a third would administer some favourite cathartic; and a fourth 
depend exclusively upon counter-irritation, such as cupping, 
blisters, &c. 

A patient is taken with pleurisy for instance, and his physi- 
cian bleeds him and the pain is relieved; on the following day 
the pain returns, and the doctor resorts to the same means which 
relieved the pain before, and in this way the bleeding is often re- 
peated until the vital powers are sinik too low to react, and 
the patient sinks from loss of blood, or if he recovers, it is ge- 
nerally by very slow degrees. 

Dr. Marshall Hall in his work on the morbid and curative ef- 
forts of the loss of blood, has given a number of cases proving 
the fact, that thougli a blood-letting may relieve pain it may 
cause the death of the patient. 

In cases of a severe bruise the old school doctrine is to bleed 
and purge, wi4h a view to prevent inflammation. When a pa- 
tient is injured inflammation is necessary, in order to repair the 
injury. This is nature* s method — injuries cannot be repaired 
without inflammation, and the more vigorous the general health 
of the patient is, the sooner will the injury be repaired, and the 
less liability will there be of the inflammation assuming an un- 
healthy character. 

An ordinary bilious or remitting fever is often converted into 
a disease of a malignant character by blood-letting. In like 
manner healthy inflammation may assume an unhealthy charac- 
ter by reducing the vital principle— the restorative power, by 
taking blood. 

That a patient may experience relief from losing blood is not 
positive proof that his condition is improved or his situation less 
dangerous by it. Taking away blood to relieve pain is as un- 



STEAM OR VAPOUR BATH. 415 

philosophical as to give arsenic or any other violent poison for 
the same purpose. The cause of disease is not removed by either 
plan. There are poisons \yhich when administered even in Ho- 
moepathic doses will relieve pain and change the form of disease 
but will not remove the cause; for although patients get w-ell 
under such treatment, it is through tlie efforts of nature in de- 
fiance of the poisonous medicines. Physicians prescribe arsenic 
in intermitting fever, which will change the symptoms — there 
may be no more ague, but a disease will remain more difficult to 
get clear of than ague. 

Pain that would be relieved by an ordinary blood-letting, 
would be more effectually removed by a Thomsonian course of 
medicine, or even by a vapour bath. Under the bleeding prac- 
tice pain is relieved by prostrating the power of reaction; where- 
as under Thomsonian treatment the circulation is equalized, and 
the obstructions removed that cause the pain. 

The fact of the matter is just this: under favourable circum- 
stances a patient may lose a large quantity of blood without en- 
dangering his life; but under other circumstances the loss of a 
few ounces would cause the death of the patient. 



STEAM OR YAPOUR BATH. 

Although the use of the vapour bath as a means of curing 
disease, w^as employed many centuries back, still the principle 
upon which it operates in removing disease, was not fully ex- 
plained, nor its utility in aiding the operation of medicine ap- 
preciated before the time of Samuel Thomson. 

The vapour bath constitutes an important part of the Thom- 
sonian system of practice, fulfiling several important indications 
in the cure of disease. It diffuses warmth through the system, 
equalizes the circulation, imparts electricity to the blood, and 
increases the sensibilities of the system to the impression of 
medicine. 

*'Ihad but little knowledge of medicine," says Samuel Thom- 
son, when through necessity I discovered the use of steaming, to 
add heat or life to the decaying spark; and with it I was ena- 
bled by administering such vegetable medicines as I then had a 
knowledge of, to effect a cure in cases where the regular prac- 
titioners had given them over." 

*'In all cases where the heat of the body is so far exhausted 
as not to be rekindled by using the medicine, and being shielded 
from the surrounding air by a blanket, or being in bed, and 



416 



STEAM Oil YArOUR BATH. 



chills or stupor attend the patient, then applied heat hy steam- 
ing becomes indispensably necessary; and heat caused by steam 
in the manner that I use it, is more natural in producing per- 
spiration than any dry heat that can be applied to the body in 
any other manner; for a dry heat will only serve to dry the air 
and ])re:ye?i^ perspiration in many cases of disease, where a steam 
by water or vinegar would promote perspiration and add a na- 
tural warmth to the body, and thereby increase the power of life 
Lnd motion and aid in removing disease." — Thomson, 

We often hear persons say that when they were bled the blood 
was almost black, and so thick that it would scarcely run, and 
they conceive that their blood was bad and had better be taken 
FvWay. The blood becomes thick and dark in consequence of its 
slow and torpid circulation for want of lieat. Place a patient 
in the condition just mentioned, in a vapour bath at a proper 
temperature, and in less than twenty minutes the character of 
this blood will be changed, so that instead of being almost as 
tliick and dark as molasses, as it was before the steaming, it 
will be of a natural colour and consistency, in consequence of 
the warmth and electricity imparted to it from the steam, which 
also restores the natural current of its circulation through the 
lungs. 

There is scarcely a form of disease or a condition of the sys- 
tem in which the vapour bath may not be employed, not only 
with safety but benefit. One of the most important objects gain- 
ed by the application of the vapour bath is adding warmth and 
electricity to the blood. It has been ascertained that in disease 
even of the most inflammatory character, the blood contains less 
electricity than it does when in a healthy condition, and by ap- 
plying the vapour bath in the early stage of pleurisy, or rheu- 
matism; the disease in many instances will be removed by it. 

Disease of an inflammatory character generally proceeds from 
cold, and the buffy coat which appears on blood drawn from one 
labouring under an inflammatory disease, may be attributed to 
the want of a suflicient amount of heat and electricity in the 
blood. Dr. Marshall Hall in his Practice of Medicine, p. 340, 
observes: *^ Some practitioners continue to let blood in most 
cases of acute rheumatism, thinking themselves justified in their 
mode of practice by the sizy appearance of the blood. The 
same principle might lead them to empty the whole sanguiferous 
system; for, every time blood-letting is repeated, the blood be- 
comes more and more dense, or sizy. I have further observed," 
says he, *Uhat, by bleeding repeatedly, the pains, swellings, 
and febrile symptoms, were not only aggravated at the time, but 
often protracted infinitelyt at least I have seen them continue, 
under such a mode of practice, upwards of two months." 

The vapour bath may be employed with immense benefit in 



STEAM OR VAPOUR BATH. 417 

disease of the urinary organs; as stranguary, gravel, retention 
of urine, inflammation of the lungs, &c. 

I have known a slight attack of jaundice cured by a single va- 
pour bath followed by an emetic. In croup where the disease 
has continued several hours, the vapour bath is almost indispen- 
sible, in order to restore the natural warmth of the blood, and 
assist the operation of the medicine. Professor Cliapman in a 
lecture last winter, said that he had recently been called to a case 
of croup in consultation W'herethe application of the vapour bath 
proved effectual after various other means had been employed 
three successive days vvithout effecting any change for the better. 
The patient continued in the bath three hours at a time. In 
croup the blood is sometimes in a condition Avhich occasions the 
formation of a false membrane in the wind pipe, w hich if not ar- 
rested finally fills up the cavity of ti;e wind pipe to such an ex- 
tent as to cause suffocation. In such cases besides the free use 
of lobelia and stimulants the vapour bath must be perseveringly 
applied with a view to restore tlie natural warmth of the blood 
and thus overcome its jjlastic condition. 

In asthma when the system is in a cold and torpid condition, 
medicine will often fail of affording much relief without t!ie pre- 
vious use of a vapour bath. In this form of disease I have found 
the hot air bath to be as effectual as the vapour bath, and it may 
be administered with much less trouble. 

Ordinary headache is speedily cured by a vapour bath. 

In dysentery and bowel complaints in general the use of the 
vapour bath is attended by tlie most signal benefit. 

In eruptive diseases, nettle-rash, small pox, scarlet fever, va- 
rioloid, and measles, the vapour bath may lie used with benefit at 
any stage of the disease. If the eruption be slow to appear, ap- 
plying a vapour bath w ill bring it out to the surface; or if there 
be a tendency to retrocession or striking in of the eruption the 
vapour bath should be applied, or at least a moist heat should be 
applied around the patient, and powerful stimulants given, as 
the third preparation of lobelia, and stimulating injections. In 
every stage of small pox the vapour bath is grateful to the pa- 
tient and aids the constitution in working off the disease. In the 
later period of small pox when scabs are forming and the patient 
much distressed, the steam bath will afford more relief than any 
other means that can be employed; and when tiie scales are dry 
and falling off there can be no better means employed for restoring 
the natural healthy condition of the skin than steaming. Scarlet 
fever and measles are very liable to be followed by dropsy, run- 
ning of the ears, swelling of the glands, &c. arising in part from 
an unhealthy condition of the skin, which may be remedied by 
steaming the patient two or three times about the termination of 
the eruptive disease. 

3 B 



418 



STEAM OB TAFOUR BATH. 



The duration of erysipelas may be shortened and the symp- 
tems mitigated by steaming, and in severe cases it should not be 
neglected. 

The vapour bath may be employed with especial benefit in all 
cases of dropsy except when the disease is incurable. 

In violent colds and catarrh where tlie breathing is greatly 
oppressed or the skin dry and husky, or cold and clammy, and 
the patient much distressed, the use use of the vapour bath be- 
comes highly necessary, not only to relieve the distressing symp- 
toms but to facilitate the operation of medicine. Thousands of 
patients die annually of consumption that in its early stage is 
curable under Thomsonian treatment. 

In all cases of falls or bruises, steaming is almost infallible; 
and is much better than bleeding, as in the common practice 
which only tends to destroy life instead of promoting it. If the 
person is not able to stand over the steam, it must be done in 
bed as has been described. Give the hottest medicine inside that 
you have, and keep the perspiration free until tlie pain and sore- 
ness abates, and the strength will soon be restored. If the ad- 
vantages of this mode of treatment were generally known, bleed- 
ing in such cases, or in any other to remove disease would never 
be resorted to by the wise and prudent." Samuel Thomson, 

In peritonitis which is a most fatal form of disease after it has 
progressed to a certain stage, the vapour bath should be prompt- 
ly and perseveringly applied, besides giving largely of lobelia 
and pure stimulants. 

In inflammation of the lungs, liver, stomach, bowels, or any 
other of the internal organs the use of the vapour bath will be 
found to relieve pain, assist the operation of medicine and shortefi 
the course of the disease. 

In << lowfevers^^ as they are called where the heat and strength 
of the patient are far reduced, I have observed marked benefit to 
result from the application of steam to the patient. A patient 
who is too weak to set up or even to raise his liead, will bear 
steaming on a couch or mattress in many instances over an hour 
without being debilitated by it, provided proper attention be 
paid to bathing the face and surface of the body occasionally 
with spirits or vinegar and giving stimulants. The most re- 
markable recoveries from ^* low malignant fevers," as they are 
termed, that I have known have been where the vapour bath has 
been administered frequently and the third preparation of lobelia 
administered freely both by injection and to the stomach. In 
these cases the steam was of course applied to the patient in bed 
or on a settee. 

The vapour bath forms an important auxiliary in the treat- 



STEAM OB VAPOUR BATH. 410 

ment of rheumatism, gout, lumbago, palsy, hysteria, chlorosis, 
neuralgia, consumption, fevers of every variety, scrofula, &c. — 
i^'inally the application of warmth to the body by means of steam 
aids the efforts of nature to overcome disease of every variety, 
that is curable by the aid of medical treatment. 

" Some who practice according to my system" (observes Dr. 
Thomson) boast of carrying their patients through a course of 
medicine in a shorter time without the trouble of steaming; this 
is easily accounted for; steaming is the most laborious part of the 
practice for those who attend upon the sick, but th& most useful 
to the patient; as one full course of medicine, in which the patient 
is steamed both before the emetic is given and after it operates, 
will in general be more effectual in removing disease than four 
emetics without the steaming." 

The steam bath affords a protection to the system against 
sickness; and wiien applied in the early stage of many forms of 
disease will effectually prevent it from becoming seated, by re- 
storing the lost heat, promoting the secretions, and removing 
obstructions. 

If the efficacy and safety of the steam bath in midwifery was 
generally known, the practice of bleeding would become entirely 
abolished; for no sensible woman w^ould willingly submit to be 
bled, who had a knowledge of the utility of steaming, and more 
especially of courses of medicine. By means of the vapour bath 
and lobelia the muscles m.ay be more effectually relaxed than by 
bleeding, and at the same time the secretions are promoted and 
nature assisted without the least possible degree of danger to the 
patient, from the treatment. 

For pain in the back and loins during pregnancy the steam 
bath may be used with much benefit. 

False labour pains will be removed by the use of the vapour 
bath; whereas true labour pains will be increased by it. This 
fact I have seen tested on many occasions. Not long since I re- 
ceived a message to attend Mrs. C g in Currant alley, wha 

it w^as supposed was in labour. The patient had regular pains 
about every fifteen minutes, which had continued over twenty 
hours. I directed a dose of composition to be given, and an in- 
jection of composition tea with a teaspoonful of green lobelia to 
be administered. These had the effect to diminish the frequency 
and intensity of the pains. A vapour bath w-as then applied 

which dispersed the pains entirely, and Mrs. C g had no 

more return of pains until the lapse of two weeks when they re- 
turned, and the same means were employed as on the previous 
occasion above spoken of, and the pains being true labour pains 
they were strengthened and aided by the same treatment that ex- 
pelled the false pains. 



420 



STEAM OR VAPOUR BATH. 



The above is only one of many instances in wliicli Iliave known 
false labour pains entirely to disappear under the use of the va- 
pour bath, lobelia and stimulants, and I have never yet seen this 
treatment fail to increase and assist true labour pains. If Mrs. 

C g had been under the treatment of the old school practice, 

and ergot had been administered, as it very often is under the 
same circumstances that attended this case, the uterus would 
have been thrown into violent spasmodic contractions, and it is 
not easy to say w hat the consequences miglit have been. It can- 
not be questioned but that in thousands of instances ergot has been 
given, and then the forceps resorted to, in cases of premature or 
false pains that v.ould have been dispersed by the use of the va- 
jiour bath, lobelia, and pure stimulants. 

In disease that comes on by paroxysms as in ague, hysteria, 
and neuralgia, a very signal influence is exerted by a vapour bath 
administered a short time before the paroxysm is expected to 
come on. 



Opinion of various writers concerning the Vapour Bath, 

^^The vapour bath is attended by the very best effects, par- 
ticularly in chronic ailments, and there can be no question that 
its action is chiefly on the skin, and tlsrough that medium on tlie 
nervous system. As a means of determining to the surface, 
promoting cutaneous exhalation, and equalizing the circulation, 
it is second to no remedy now in use; and consequently, in a va- 
riety of affections which this process is calculated to relieve, it 
may be employed with Gse,vy prospect of advantage.'' — Combers 
Fhijsiology. 

** To tiie v;ars between Napoleon and Russia is western Eu- 
rope indebted if for nothing else, to the introduction of vapour 
baths. Prussian soldiers having constructed them in the north 
of Prussia, some of the Prussian physicians were induced to ob- 
serve the effects of this new fashion of bathing. They soon 
found that it cured various diseases, such as I'lieumatism, and 
cutaneous affections, and were not slow in giving notoriety 
throughout Germany by means of various juiblications. Tlie 
king of Prussia caused a bath to be constructed at his palace; 
and in 1818, the Princess Marianne, sister-in-law of this sov- 
reign was present at the opening of the first public vapour bath 
at- Berlin and allowed it to receive her name." — Eclectic Journal 
of Medicine. 

"Of all Turkish remedies the vapour batli is the iirst and 
most efHcacious in rheumatism and cutaneous diseases. I have 
seen them removed in one fourth part of the time in which they 
are commonly cured with us.'' — Br. Madden. 

*^If life be nothing but a brief succession of ideas, the rapid- 



STEAM OS VAPOUR BATH. 42 1 

ity with which they now pass through the mind would induce 
one to believe, that in the few short minutes which he has spent 
in the bath, he has lived a number of years." — Sir John Sinclair. 

'' The vapour bath may be used with decided advantage in ail 
seasons, as it is in Prussia, and in Asiatic countries. It 
is a vulgar error, contradicted by general experience, to sup- 
pose that vapour, or warm bathing, is contra-indicated in win- 
ter, as disposing those who bathe to contract colds." — Doctor 
Schmidt. 

'' Major Long, who made an expedition to the Rocky Moun- 
tains subsequent to the time of Lewis and Clark, informs us, 
also, that the Indian sweating baths, as he terms them, are in 
high repute for the cure of many disorders. He remarks, that 
they are generally constructed near the edge of a water course, 
and formed of pliant branches of trees, stuck into the ground in 
a circle, bent over at the top and covered in every part with bison 
robes. Some of them contain only one person and others four 
or five. The invalid enters with a kettle of water and some 
heated stones, on which the water is sprinkled until the requisite 
degree of steam is produced. When it is thought that the per- 
spiration is sufficiently profuse, the patient is taken out and 
plunged into the water, previously breaking the ice if the stream 
is frozen. He is is not subjected a second time to the action of 
the steam but covers himself with his robe and returns home." 
Mattson^s American Vegetable Practice. 

** Lewis and Clark mention a remarkable cure which was 
performed with the vapour bath, during their expedition. One 
of their men had so great a weakness in his loins, that he could 
not walk, nor even sit upright without extreme pain. They ex- 
hausted the resources of their art upon him in vain, and at leogth 
at the suggestion of an Indian hunter, and at the request of the pa- 
tient himself, they placed him in a vapour bath, with the steam 
as hot as it could be borne. In twenty minutes he was taken 
out, plunged twice in rapid succession into cold water, and re- 
turned to the bath. During this time he drank freely of horse- 
mint tea. At the end of three quarters of an hour, he was again 
withdrawn, carefully wrapped, and suffered to cool gradually. 
The morning after the operation, he was able to walk and nearly 
free from pain." — lb. 

The prevalent fear of catching cold, which deters many from 
using the vapour bath, even more than fi'om warm bathing, is 
founded on a false analogy between its effects and those of pro- 
fuse perspiration from exercise or illness. The latter weakens 
the body, and by diminishing the power of reaction renders it 
susceptible of injury from sudden changes of temperature. But 
the effects of the vapour bath properly administered are very dif- 
ferent. When not too warm or too long continued, it increases 



492 



STEAM OR VAPOUR BATH. 



instead of exhausting the strength, and by exciting the vital ac- 
tion of the skin, gives rise to a power of reaction which enables 
it to resist cold better than before. — Combers Fhysiology, 

HOT AIR BATH. 

VAmors kinds of apparatus have been constructed for the pur- 
pose of applying the heat from burning alcohol to the body for 
the cure of disease. The following method v/ill do very well 
where there is no apparatus for the purpose at hand, namely: — 
Place a teacup two-thirds full of alcohol, or any kind of spirits 
that will burn, in a bowl containing sufficient cold waterto come 
witliin half an inch of the top of the cup. Set these under a 
wooden bottomed chair, about the centre; place the patient on 
the chair, remove all clothing and throw a quilt over the patient 
and chair, leaving the head uncovered. Set tire to the alcohol 
under the chair, and if it becomes too hot, the quilt may be rais- 
ed at the bottom so as to admit cold air. In applying this bath 
care will be necessary to prevent the cover from coming in con- 
tact with the blaze. When the patient becomes oppressed with 
the heat the face and breast must be washed with cold water, 
vinegar or spirits. 

Mr. Pendleton of this city, invented an apparatus by which 
steam is produced by the blaze from burning alcohol, rendering 
the hot air less dry and oppressive to the patient. This apparatus 
was constructed upon the principle of a chafing dish. The lamp 
four or five inches in diameter, with eight or nine wicks, and a 
tin basin set in a frame over the lamp. By pouring hot water 
into the basin and lighting the wicks steam is generated in suffi- 
cient quantity to render the air from the burning lamp sufficient- 
ly moist, to answer in most cases the place of a regular vapour 
or steam bath. 

Where the skin is cool, relaxed and tending to perspiration, 
as in chronic rheumatism, asthma, &c. the hot air bath may be 
employed in place of the steam bath. 

A quilt is preferable to blankets for covering the patient when 
the vapour or hot air bath is applied. If blankets or sheets be 
employed they should be clean, otherwise the air in the room 
will become contaminated with foulness. 



PARTIAL STEAMING. 

The plan of applying steam to the lowerhalf of thebody, was 
first introduced by Dr. A. C. Logan. To administer the hip 
vapour bath the cover must be fastened around the waist, instead 
of the neck. It is particularly applicable to cases of palsy of 
the lower extremities, hip disease, white swelling, indolent ul- 



EMETICS. 423 

cers on the limbs, obstructed menstruation, strangulated hernia, 
swelled testicles, and dropsy of the legs. Applied in this way to 
the lower half of the body it may be borne without inconvenience 
for an hour or even several hours together, and much credit is 
due Dr. Logan for this method of steaming in certain cases. 

Toothache, pain in the face, swollen and painful breast, may 
be relieved by the application of steam to the affected part. 

In cankered sore throat, scarlet fever, quinsy, and in sever© 
colds attended with dryness of the throat and oppressed breath- 
ing, benefit may be derived by inhaling the vapour from hot vin- 
egar and water. 

The following is from Constable's Miscellany, as given by the 
celebrated Urban Clievreau, Secretary to Christine of Sweden. 

CURE OF FEVERS IN SWEDEN. 

** One thing which I saw in Sw^eden surprised me. The pea- 
sants who have fever, take a quantity of beer, into which they 
put ginger, cloves, cinnamon, and having heated it as much as 
their mouth and stomach will bear, they drink it off. The prac- 
tice is successful." 

" They have also another remedy which would appear a 
startling one to inhabitants of our climate. They have dry 
stoves which they call bastou, into which they enter naked, and 
when the perspiration is profusely produced on all the body by 
the heat of the stove, they immediately come out, and lie down 
among the snow, or, if they can swim, throw themselves into 
the water. Our physicians may judge how far their aphorisms 
agree with the experience of these peasants.*' This was pub- 
lished during the life of the author who died in 1701 and may 
serve to show to the incredulous /flci<^^2/ that steaming is no new 
doctrine and it also exhibits a striking analogy to the practice 
of our North American tribes in cases of fever. 



OF THE UTILITY OF EMETICS IN THE CURE OF 
DISEASE IN GENERAL. 

THOMso]>fiA«^ emetics constitute the most effectual remedy em- 
ployed in the treatment of disease. There is scarcely a form or 
variety of disease in which the use of emetics will not prove be- 
neficial, and in many intances they are indispensably necessary 
to the recovery of the patient. 

Previous to the discovery of the medical properties of lobelia 
by Samuel Thomson, poisonous articles were employed almost 



424 



EMETICS. 



exclasively as emetics. Even now the medical profession con- 
tinue to prescribe the same deleterious articles, notwithstanding 
the evidence afforded of the efficacy of lobelia emetics in cleans- 
ing the stomach, and likewise knowing — as they might know if 
they would that it possesses no deleterious qualities. 

In some cases of slight or sudden attacks of disease, all that 
is required by the operation of an emetic is merely to throw off 
the foul contents of the stomach, which had oppressed and dis- 
tended its functions. But where disease has become seated, 
other important objects are obtained by the operation of Thomso- 
nian emetics. They relax the system, and in this way overcome 
obstructions, equalize the circulation of the blood, and of the 
nervous influence; invigorate the energies of the stomach, and 
remove morbid secretions from its mucous surface; restore the 
secretions, and in fine to assist the constitution in resisting dis- 
ease, and thus aid her efforts in restoring to health. 

Whenever there is a general fever pervading the body, it is 
evidence of a diseased condition of the stomach; and hence in 
fever, the use of emetics are particularly indicated. Whether a 
fever arise from the cause of undigested food in the stomach, 
worms in the intestines, its energies sunken or its functions 
prostrated by the poisonous influence of marsh effluvia, or from 
previous exposure to cold, Thomsonian emetics are indicated. 

In measles, scarlet fever, and small pox the disease will be 
rendered more mild in its character, less dangerous, and some- 
times of sliorter duration by the early administration of a Thom- 
sonian emetic. 

In diseases of children, emetics constitute by far the most effi- 
cient remedy. Vomiting is nature's method of relieving the sto- 
mach in infancy. We can scarcely do wrong in giving emetics 
to sick children, more especially at an early stage of disease. — 
In cases of sudden attacks of fever, croup, convulsions, &c. lo- 
belia should be given freely, either tlie powder in warm teas or 
in simple warm water, the tincture, or tlie third preparation — 
The latter is particularly adapted to cases of spasms, and in 
cases where the heat of the system is very low, and in the ad- 
vanced stages of disease. No danger need be apprehended from 
vomiting a child too much in croup, nor in any other violent at- 
tack of disease; nor of relaxing the system too much with lobe- 
lia. 

In protracted chills, where tlie patient is in a stupor, the 
tliird preparation of lobelia sliould be given freely, witli the ap- 
plication of external warmth and friction to the surface with a 
view to bring on reaction. 

" Emetics" (observes Professor Chapman) however beneficial 
they may operate as mere evacuants, produce effects not less sal- 
utary in another way. Whatever may be the cause, fever as 



EMETICS. 425 

lias already been shown, is a result of sympathy, having, for the 
most part, the primary link of its ultimately lengthened and com- 
plex chain, in tfie stomach. To expel, therefore, the offending 
cause, or to subvert the nascent impression which may be 
created, before it becomes invigorated, diffused, and fixed, vomit- 
ing is obviously the remedy." 

*^ Erysipelas of the face, I have benefitted, or entirely re- 
moved by vomiting — and in several instances, have derived 
scarcely less advantage from the same remedy, when the brain 
becoming affected, stupor has supervened." 

Emetics administered in the early period of scarlet fever will 
sometimes exert a most signal influence in moderating the vio- 
lence, and in shortening the duration of the disease. 

In case of bleeding from the lungs the effect of the operation 
of emetics is to attract blood from the lungs and diffuse it 
through the system by which the bleeding will be checked. — 
Warm foot baths, or the vapour bath should be employed to aid 
in restoring the natural equilibrium of the circulation of the 
blood. ^' In support of this practice, it may be proper to men- 
tion, that it appears on good authority, that tlie late Dr. Willis, 
so celebrated for his skill in the treatment of mania, and especi- 
ally the cure of George III. of England, resorted to emetics in all 
cases of hemoptysis" (bleeding from the lungs) and declared that 
the lengthened experience of nearly half a century had taught him 
to confide in them above all other means as well on account of 
their safety as efficacy." Chapman^s Therapeutics. 

In bleeding from the stomach in which case blood will be 
raised by vomiting, the employment of active emetics are indi- 
cated, not only for dislodging accumulations of blood in the 
stomach, which may have oppressed its energies; but to cause 
a distribution of blood throughout the system, and to strengthen 
the weakened capillary vessels of the mucous membrane of the 
stomach. I have found the third preparation of lobelia given 
freely, together with the application of tiie vapour bath, to be 
successful on several occasions of bleeding from the stomach, 
and have never known it to fail in checking the hemorrhage. 

In uterine hemorrhage the flow of blood may in general be 
controlled by active emetics, aided by the use of stimulating 
enemas to the bowels. 

In severe colds and sore throat; either from inflammation or 
the existence of ulcers, emetics are of great utility. 

Emetics are more effectual than any other remedy in th^ cure 
of consumption, bronchitis, and other forms of disease of the 
chest. 

The most severe paroxysms of asthma may be overcome by a 
thorough emetic, more especially when the emetic is preceded by 

3 C 



426 



EMETICS, 



the application of a vapour bath, rendering the system more 
sensitive to the impression of medicine. 

In pleurisy and inflammation of the lungs, emetics may be 
employed with great advantage, more especially in the early 
period of the disease. I have never observed the act of vomiting 
to be attended with much pain or difficulty in the most violent 
cases of pleurisy and inflammation of the lungs. As a patient 
sickens the system becomes relaxed, which affords an explana- 
tion why a patient may vomit with so little pain or difficulty 
when there is active inflammation in tlie pleura or lungs. 

^*In their wide and pervading operation they (emetics) sub- 
due or have a tendency to subdue vascular action, to remove cuta- 
neous constriction, promote absorption from the lungs, facilitate 
expectoration, lessen dyspnoea, cough and sanguineous discharge, 
to calm the system by equalizing excitement, and thus re-esta- 
blishing that just balance in the distribution of the blood, on 
which the restoration and maintenance of health so materially 
depends." 

In whooping cough more benefit may be derived from the use 
of emetics than from any other remedy. In violent cases an 
emetic should be given daily, or even two or three times a day. 
In those cases when violent paroxysms of coughing are observed 
to come on at certain periods, it is a good practice to place the 
patient under the influence of lobelia, given even to the amount 
necessary to cause free vomiting previously to the time at which 
the paroxysm of coughing usually comes on. 

Emetics form an important part of the treatment for rheuma- 
tism, lumbago, gout, neuralgia, &c. No remedy under my ob- 
servation has produced so much relief in these forms of disease as 
active emetics; their efficacy will be greatly enhanced by the 
previous application of a vapour bath. 

Of the various remedies that have been employed in the treat- 
ment of dyspepsia, emetics have proved the most successful. — 
Even in cases where there is extreme tenderness at the pit of 
the stomach, an emetic after a vapour bath will afford more re- 
lief in general than any other remedy. In the early stage of 
dyspepsia digestion, in most instances, may be restored by one 
or two active emetics, followed by the free use of cayenne pep- 
per at meals. 

Sick-headache depending upon a disordered condition of the 
stomach may be more speedily relieved by a prompt emetic than 
by any other remedy. Besides the speedy relief which the ope- 
ration of emetics afford, they sometimes break up the disease al- 
together, the patient being freed from subsequent attacks. 

Emetics are well adapted to the cure of every variety of colic, 
or cramp in the stomach. " To induce general relaxation, and 



EMETICS. 42T 

to excite the biliary secretions, a deficiency or suspension of 
which, he considers as an accessary cause of some of the cases 
of obstinate constipation in colic. Professor Hosac has given 
emetics, as he states, with great success." — Chapman, 

In diarrhoea, dysentery and cholera morbus, digestion is lost, 
and the stomach contains more or less foul matter, and its mu- 
cous surface is coated with thickened secretions, oppressing its 
functions, which increase the distress of the latter, and favour 
the disease. Hence to excite free vomiting is particularly indi- 
cated in the cure of such disorders. Besides relieving the sto- 
mach of foul matters, Thomsonian emetics exert a beneficial in- 
fluence upon the secretions, cause a determination to the surface, 
restore capillary circulation, and aid the efforts of nature to re- 
store healthy action in the mucous membrane of the bowels. 

Epilepsy, or falling sickness, is in many instances occasioned 
by an oppressed or otherwise disordered state of the stomach, 
demanding the use of emetics. "By exhibiting them just be- 
fore the accession of the paroxysm, they will often prevent it, 
and even if they fail in this respect, they render it milder and of 
shorter duration. Nor is this all which they accomplish. By 
the strong and direct impression made on the stomach, the com- 
mencement in that organ of the wrong association constituting 
the disease, is broken, and afterwards it yields more readily to 
tonics." 

*' Nearly the same views, I think, may be taken of hysteria. 
Even admitting that the disease is mostly radiated in the uterus, 
it does unquestionably often proceed from gastric irritatioia, and 
demands to be treated accordingly. Whatever may have been 
the immediate cause of the paroxysm, I have found, when ex- 
ceedingly vehement, no remedy half so effectual as vomiting. 
It promptly allays the convulsive agitations of the nervous sys- 
tem, and produces a state of mental composure which invites to 
sleep. " — Chap man. 

Apoplexy brought on, as it often is, by a mass of undigested 
food in the stomach, calls for the free exhibition of emetics, of 
which the third preparation of lobelia is the most appropriate. 
Lobelia should also be administered by injection and allowed to 
be retained in the bowels, to assist in exciting vomiting, relax 
the system, and equalize the nervous influence. Even if the 
seat of apoplexy be in the brain, and incurable, as it often proves 
to be, still the treatment can do no harm. 

Mania is generally associated with, and not unfrequently de- 
pendent upon a disordered condition of the stomach. Many 
cases have been cured by free vomiting with stimulating emetics. 

In long-continued dyspepsia, as in other forms of seated dis- 
ease, the mucous membrane of the stomach becomes more or less 
coated with a false membrane; a general torpor then pervades 



4£8 



EMETICS. 



the system, the nervous energy is prostrated, and tlie energies 
of the mind often greatly depressed. In such cases there is no 
plan of medical treatment which promises equal success with 
that of the frequent use of the steam hath and stimulating 
emetics. These means will prove the most effectual in restor- 
ing the secretions, and causing tlie detachment and removal of 
the false merahrane Huing the stomach. Without effecting this 
the functions of the stomach cannot be restored. I have on many 
occasions observed that patients who had been long affected with 
dyspepsia, are very liable to experience severe pain under the 
operation of an emetic, and often complain of feeling worse about 
the time the disease is taking a favourable change. 

Affections of the head in general proceed from derangement 
of the stomach, so that not only in sick-headache are emetics in- 
dicated, but the most violent neuralgic pains in the head, ac- 
companied with extreme tenderness of the scalp, will sometimes 
he promptly relieved by free vonsiting. ** Early adopting the 
notion," says Br. Chapman, *^ that this complaint proceeds from 
a morbid condition of the stomach, the only two cases of it which 
have come under my care, I have managed by emetics, and had 
reason to be entirely pleased with the result. Even genuine 
tic-dolcreux, the neuralgia of some writers, has been cured, in 
several instances, by this same practice, and with such facility 
as to place it, in my opinion, decidedly above all other modes of 
treating this most painful, and hitherto nearly unmanageable 
affection." 

Diseases of the eye, as amaurosis, and acute inflammation of 
this organ, have been more successfully treated by active 
emetics than by any other plan. It is in the early stage of 
amaurosis, however, that so much reliance is to be placed upon 
emetics. 

The operation of emetics in connection with the use of the 
vapour bath are applicable to cases of dropsy. Besides clean- 
sing the stomach, placing the system under the relaxing influ- 
ence of lobelia promotes the action of the absorbent vessels, and 
consequently the use of this remedy is particularly well adapted 
to cases of dropsy. 

Emetics form an important part of the treatment for the cure 
of jaundice. I know a case of this form of disease which was 
cured by the administration of a vapour bath and an emetic, the 
patient having taken freely of composition and compound lobelia 
pills a few days preceding the bath and emetic. Cases that 
are more deeply seated, however, will require as do other forms 
of seated disease a repetition of courses of medicine, together 
with the appropriate intermediate treatment. 

An occasional emetic will be serviceable in every variety of 
scrofula. 



EMETICS. 429 

Persons labouring under the poisonous effects of mercury will 
experience benefit from the use of the vapour baths and emetics. 

It is asserted by some medical writers that diabetes has been 
cured by t4ie operation of emetics. This disease, however, is 
often incurable, as in many instances it is the consequence of 
the wearing out of tlie constitution. 

Torpor of the liver, which attends jaundice and bilious fevePy 
has frequently been removed, and the functions of this important 
organ restored through the influence of vapour baths, and active 
emetics. To restore the natural temperature of the blood and im- 
part electricity to it, by the steam bath; to relax the system 
with lobelia; together with the influence of straining efi'orts to 
vomit constitute the most effectual means of relieving congestion 
of the liver, and of restoring its functions. Lobelia administer- 
ed by injection, and retained, exerts the same beneficial influence 
upon the system as when taken into the stomach. 

Whenever the system experiences a severe shock, as by fall- 
ing from a height, a violent blow% or by a severe burn or scald, 
digestion will be suspended, and if the accident should happen 
soon after, or within an hour or two after the patient has taken 
a hearty meal, the stomach should be evacuated by an active 
emetic. This may save the patient a great deal of suffering and 
materially lessen the danger of the injury. 

Thomsonian emetics may be employed with perfect safety du- 
ring every stage of pregnancy; and most of the derangements of 
the system consequent upon that state, such as a feeling of fulness, 
dizziness, or violent pain in the head; pain and distress in the 
back and loins; extreme sickness; water brash; and distress at 
the stomach, may be relieved and frequently entirely removed, 
for a time at least, by an active lobelia emetic preceded by the 
use of an enema, and a vapour bath. I have known females to 
be carried through from three to nine Thomsonian courses of 
medicine during the last two weeks preceding their confinement, 
invariably deriving benefit, and generally complete relief from 
distress, by their operation. A full course of medicine adminis- 
tered just before confinement is incomparably the best plan of 
treatment that has ever been adopted for insuring an easy and 
safe labour. 

Child bed fever, convulsions, and other forms of disease which 
sometimes come on after confinement, doubtless in the great ma- 
jority of instances may be prevented, or at least the system be 
placed in a far better condition to resist the influence of the usual 
exciting causes of disease, by a course of medicine administered 
in the first stage of pregnancy. 

The condition of the stomach excites a controlling influence 
over local diseases, such as painful swelling in ewery part of the 



430 EMETICS. 

body, swelled breast, and swellings in tbe groin, neuralgia, 
local inflammation, gout, disease of tl)e kidneys, carbuncle, af- 
fections of the spine, abscesses, &c. In the early stage painful 
swellings in the groin and in other glands may in many in- 
stances be brought to a crisis and dispersed without suppuration 
talving place, by administering vapour baths and emetics, to- 
gether with a proper use of injections to assist the action of the 
bowels. 

Just so much as the stomach is disordered will local diseases be- 
come generally more difficult of cure. I have known indolent 
ulcers of several years standing to be healed in a few weeks, 
chiefly by improving the condition of the system generally and 
more particularly that of the stomach, by Thomsonian courses of 
medicine, of which the emetic constitutes undoubtedly the most 
important part of the treatment. 

Even when the seat of disease is located principally in the 
brain, emetics may be given with great advantage in many 
cases. 

If a person be injured on the head or on any part of the body, 
and the accident occur soon after the patient has taken a hearty 
meal, a prompt emetic should be given, or the patient be made 
to vomit freely by some means. If this be neglected the stomach 
will be oppressed by a mass of undigested food, aggravating the 
symptoms, and causing tlie patient much suffering. 

When any poisonous substance has been swallowed, an emetic 
should be given promptly. The third preparation of lobelia is 
the most effectual form of emetic in such cases. 

When any substance is lodged in the throat, means should at 
once be taken to cause vomiting. Where this cannot be effected 
by running a finger into the throat, an emetic of lobelia should 
be given. If the patient cannot swallow an emetic, vomiting 
may be effected by administering one or two teaspoonsful of lo- 
belia powder in warm water by injection, and retained in the 
bowels. Besides producing vomiting this treatment will relax 
the system and thus tend to overcome the rigity of the parts in 
which the foreign substance is lodged, and lessening the difH- 
culty of its being removed. 

Finally in disease, the stomach is more or less coated with 
thickened tenacious secretions, for the removal of which there is 
no remedy so effectual as a lobelia emetic given in combination 
with capsicum and a strong decoction of bayberry or sumac. 

The stomach possesses a very low degree of sensibility, so that 
its functions may be greatly depressed or disordered without the 
patient experiencing any symptoms of disease, except in parts re- 
mote from the stomach. One who is subject to a weakness in 
any part of the spine will experience an increase of the disease 
by the stomach becoming more disordered than usual. In many 



OF THE USE or CATHARTICS. 431 

instances disease of the spine has been cured by the use of the 
vapour bath and emetics. 

Eruptions of the skin, such as scald hand, nettle-rash, and tet- 
ter, are occasioned in general by derangement of the digestive 
functions and these eruptions may frequently be more effectually 
cured by emetics than by any external applications. 

The operation of an emetic and more especially of a full 
course of medicine is of especial benefit as a means of preparing 
the system for surgical operations. 

Case A few months since I was desired to visit the wife of a 

gentleman a few miles from the city, who it was supposed was 
labouring under cancer of the uterus. She had been subjected to 
frequent purgings, several large bloodlettings, and she was often 
cupped. This course of treatment proved not only useless but 
the patient was getting worse under it. On commencing taking 
Thomsonian stimulants she began to improve; a few courses of 
medicine were given from which she experienced great benefit. 
They equalized the circulation, removed the swelling in the lower 
part of the abdomen, relieved the pain and soreness, under which 
she had been labouring, and finally by the daily use of tonics and 
an occasional vapour bath, and enemas per vagina and also to 
the bowels the symptoms of cancer of the uterus have almost en- 
tirely disappeared, and the general health of the patient is re- 
stored. The above is only one of hundreds and even of thou- 
sands, where the employment of Tliomsonian emetics have 
proved successful in removing seated diseases when the regular 
practice had failed of doing any good whatever. 



OF THE USE OF CATHARTICS, OR PURGATIVE 
MEDICINE. 

Every substance which operates upon the bowels as an active 
cathartic whether it be mineral or vegetable is injurious. — 
There is a wide difference between restoring the natural action 
of the bowels by aiding nature, and that of provoking an unnatu- 
ral action in them by means of cathartics. 

We know the general effect of cathartics in a diseased state of 
the system, by ascertaining their effect upon the system when in 
a healthy condition. Every physician will at once admit that 
the use of cathartics is injurious to persons in health— directly 
tending to disorder the stomach, impair digestion, lessen the de- 



432 OF THE USE OE CATHARTICS, 

termination to the surface, weaken the power of generating heat, 
diminish the nervous influence, and ultimately prostrate the 
functions of the bowels. If a person in health take daily a dose 
of purgative medicine sufficient to produce a free operation, and 
continue the practice a few days, it will disorder the stomach 
and wxaken the functions of the bowels, so that they will be left 
either relaxed and irritated, or constipated. 

Costiveness is the consequence of the peristaltic action of the 
bowels being in a weakened condition. Hence costiveness is the 
effect and not the cause of disease; or at least it is merely one 
link in the chain of effects arising from loss of vital power, or a 
weakened condition of the principle of life. 

A patient applies to a physician for advice. He tells the doc- 
tor that he has pain in the head; feels very drowsy and heavy; 
and has no appetite. The doctor enquires about the condition of 
the patient's bowels, and ascertaining that they are in a consti- 
pated condition; discovers a cause for the headache and drowsi- 
ness, and he directs a cathartic in order to remove the difficulty. 
But the enquiry should have been extended further to ascertain 
the cause of the costiveness, and ^^ apply the axe to the root of 
the tree," instead of employing means which merely change the 
symptoms, and interfere with the curative operations of nature. 
By tracing disease to its primary source, we find it to arise from 
loss of vital power, and this should always be kept in view in the 
treatment of disease. Medicines often get the credit of curing 
disease, even where they may have had the effect to increase the 
distress of the patient and lengthen the duration of disease. 

It is no easy matter to determine the effects of some medicines 
in slight attacks of disease, or in acute disease in general. — 
Thus a person by some inaccuracy in diet, or from exposure to 
cold and dampness, feels indisposed to day, takes a dose of salts, 
eats nothing or at least only sometliing very light, keeps him- 
self warm, the physic operates and to-morrow he will be almost 
well again, except that he will be costive a few days in conse- 
quence of the salts he had taken. The patient attributes the re- 
storation of his health to the dose of salts, yet doubtless his 
health would have been as speedily and more perfctly restored 
by the abstinence which he had observed and being kept warm, 
without the purging. 

Purging like blood-letting will modify the symptoms without 
removing the cause of disease; ultimately tending to disorder the 
system, and prostrate the vital forces. It will be admitted by 
every physician that in a sunken state of the system, or in very 
aged persons, the use of purgative medicine is not only hazard- 
ous but, in many cases if given to the extent of exciting free 
purging they would cause the death of the patient. 

It is by the efforts of nature that disease is cured. Medicines 



OF THE USE OE CATHARTICS. 433 

^re only serviceable when tliey nid the efforts of nature. When 
the stomach is foul, a dose of composition, or bayberry tea, is 
apt to cause vomiting; not because the medicine possesses emetic 
properties, but that the sensibility of the stomach is increased, 
and by being made to feel its diseased condition it makes an ef- 
fort to evacuate its foul contents. The stomach may thus be 
excited to vomiting by the use of medicines that are not in the 
least degree deleterious, and taken by one whose stomach is 
either in a healthy or a very insensible condition, will not occa- 
sion the least degree of nausea; and if taken freely every day 
would not prove injurious to the stomach, nor even derange the 
appetite. Lobelia, tlie best of all emetics, does not possess poi- 
sonous or deleterious qualities, and doubtless occasions vomiting 
partly by increasing the sensibility of the stomach. Antimonial 
wine, tartar emetic, and sulphate of zinc are poisonous, and when 
taken into the stomach nature makes an effort to cast off the of- 
fending substance by the act of vomiting. Thus by one plan of 
treatment we aid the stomach, whereas by the other the stomach 
is aggravated and its functions deranged. 

Cathartics are agents which do not harmonize with the laws 
of life, and when taken into the stomach the constitution makes 
an effort to remove the offending substance by purging. The 
deleterious influence of cathartics provokes the bowels to action 
upon the same principle that a portion of tainted meet will pro- 
duce looseness of the bowels and violent purging. 

It is urged by some that many diseases pass off wit?i a loose- 
ness of the bowels, ancl that nature sanctions the propriety of 
purging. But it should be borne in mind that the forced action 
from a cathartic is different from the action which results as a 
consequence of the bowels recovering their functions at the crisis 
of disease. Jn the first case the bowels are aggravated and pro- 
voked to action, whereas in the latter it is the recovery of 
their lost functions. 

Some have endeavoured to prove the advantage of using cath- 
artics by selecting a few isolated cases, where especial benefit 
appeared to result from their employment, the medicine having 
been given at a favourable period of the disease. Tlius a patient 
may have several courses of medicine administered, which may 
bring the disease almost to a crisis, and just at this time take a 
dose of cathartic medicine, and the next day the disease be bro- 
ken up, not in consequence of having taken a purge, but because 
the disease was forming a crisis when the cathartic was taken, 
and although it does more harm than good, still the disorder be- 
ing just at its termination, the patient would improve more ra- 
pidly, and very erroneously suppose that he had received more 
benefit from the cathartic than from courses of medicine. 

I have known patients relieved of rheumatic pains by bjeing 

3 D 



434 



0¥ THE USE OE CATHARTICS. 



freely purged with powerful cathartics; but I have never yet seen 
a patient really benei^ted or the cause of disease removed by 
such treatment. 

A physician may obtain a large practice, whose course of 
treatment may in qygvj instance be detrimental to the recovery 
of his patient, nature still struggling against the disease and the 
treatment, health becomes restored, and the doctor receives much 
credit for his skill/ more especially where a patient recovers 
who has been nearly deprived of vitality by his treatment. 

There are thousands of persons in the community who con- 
tinue in bad health year after year, in consequence of the habit- 
ual use of purgative medicines. After commencing the use of 
purgatives t!ie bowels being weakened by them, they become 
more costive; to overcome this more physic is taken, which 
may relieve, but it weakens digestion, and is followed by increas- 
ed torpor of the bowels. I have frequently conversed with per- 
sons who had been in the habit of taking a dose of purgative me- 
dicine regularly once a week or oftener, and had continued in 
this practice from live to fifteen years; the bowels finally becom- 
ing so torpid as scarcely ever to be moved except provoked by 
the irritating effects of a cathartic; whereas if no purgatives 
had been used many of these patients might have enjoyed good 
health. 

The exclusion of cathartics constitutes one of the distinguish- 
ing features of the Thomsonian practice of medicine, and no one 
can justly claim the title of Thomsonian who is in the habit of 
prescribing either mi7ie7'al or vegetable cathartics. It is incon- 
sistent to denounce all mineral poisons, and at the same time 
administer vegetable poisons, such as mandrake, an article 
which has been laid aside by the medical profession generally as 
too irritating to be used with safety; and yet many who claim 
to be Thomsonian doctors employ mandrake to a great extent 
in their practice. Castor oil which is one of the mildest cath- 
artics, occasions purging, because it is indigestible and offensive 
to the stomach and bowels. 

I once heard Dr. Samuel Thomson make the remark, that the 
practice of taking physic (purgatives) was like borrowing from 
Peter to pay Paul — which may afford some relief, but does not 
diminish the debt. In like manner a dose of purgative medicine 
may afford relief, but it does not remove the cause of disease. 

In treating cases of constipation of the bowels, even of long 
standing, I have in many instances been agreeably disappointed 
by finding their natural action to be in a great measure restored 
in the course of from two to four weeks under a course of treat- 
ment in which no purgatives were used. 

In certain conditions of the stomach and bowels, for instance, 
when they contain a portion of acrid secretions, the use of medi- 



OF THE USE OE CATHARTICS. 435 

cine that possesses no cathartic properties, may be followed by- 
purging. Thus cayenne pepper or composition powder, taken 
freely when the bowels contain a superabundance of acids, will 
increase the sensibilities of the mucous membrane, and may 
cause the acid or acrid secretions to operate as a purgative. — 
But by continuing the use of composition or pepper until the acid 
is removed, the medicine may be taken in increased quantities 
and no cathartic effect will be produced. In like manner a dose 
of purgative medicine may be made to operate by giving stimu- 
lants to increase the sensibility of the bowels to the morbid im- 
pression of the cathartic, and stimulating the restorative efforts 
of nature to cast off the deleterious substance. 

A deficiency of bile, in consequence of want of action in the 
liver is a very common cause of costiveness, and under these 
circumstances cathartics are decidedly injurious. 

The object to be kept in view in the treatment of disease is to 
aid the efforts of nature; to husband the resources of the consti- 
tution, in order that lost action may be restored. iSJature has 
established certain methods for removing disease, and for re- 
gaining her lost power, and the use of medicine or other employ- 
ment of means that do not harmonize with tliese curative actions 
though they may change the symptoms and procure relief, still 
the designs of nature will be frustrated, and her energies crip- 
pled. In illustration of what I have here asserted, I will sup- 
pose a patient who is sick of what is termed bilious fever, to be left 
entirely in the hands of nature, except so far as to take simple 
warm teas and be protected from all injurious influences. — 
Watching the progress of the case we find the fever continuing 
without any abatement, except at short intervals in the morning; 
the tongue becomes even more thickly coated, the bowels re- 
main costive, and all the symptoms continue, without any per- 
ceptible change until the ninth day, for instance, and then we 
perceive the edges of the tongue beginning to clean, the bowels 
are moved freely, the fever abates, perspiration ensues, and the 
patient gets well, say in a few days. Now under such circum- 
stances by what method is disease removed? It is by the con- 
stitution *Mmsbanding her resources" — retaining the heat by 
which these actions are sustained, which resist the influence of 
the causes of disease, and by which the secretions and all other 
functions are fully restored. Now^ suppose this patient had been 
placed under the treatment of a physician of the old school, and 
an active cathartic had been given, causing a free operation upon 
the bowels, would this have restored the lost function of the 
bow^els? No: it would have aggravated the bowels and drained 
the system of a portion of its strength. In this way, by fre- 
quent purgation and blood-letting, disease is undoubtedly pro- 
longed to four or five weeks duration, which if left in the hands 



456 



INJECTIONS OR ENEMAS. 



of nature alone, would have found a crisis in less than two weeks 
and the patient suhjected to much less suffering. 

There are means, however, hy which nature may he assisted, 
the duration of disease sliortened, pain relieved and life prolong- 
ed. To Dr. Samuel Tliomson are we indehted for the detection 
and exposition of the errors of the regular practice of medi- 
cine; the discovery ofihejirst jmnciples of medicine; and of a 
system of practice which does not clash with nature^s efforts^ 
hut operates in harmony with life; and when properly apjdied 
will prove the most speedy and effectual means of restoring 
health that has ever heen introduced. 

It has heen urged as an objection to the Thorasonian practice 
that all diseases are treated alike, or that the same remedies 
are used in all cases. The fact that Thomsonians treat disease 
upon general principles, without regard to the name of disease, 
is in reality a strong point in favour of its correctness. Thus 
a thousand different forms of disease may be produced by one 
general cause, and that course of treatment that will assist na- 
ture in one form of disease will do it in another. And again, 
the same course of treatment that will cleanse the stomach when 
it has become disordered by exposure to cold, will also do the 
same when disordered through inaccuracies in diet, dissipation, 
loss of rest, exposure to foul air, &c. &c. &c. 



INJECTIONS OR ENEMAS. 



Many important objects may he accomplished by the use of 
injections in cases of sickness; and in many instances they con- 
stitute the most important means for the cure of disease. 

In disease, the bowels are generally either constipated or ef- 
fected with diarrhoea, and in eitlier case the use of injections, 
though not always necessary, may nevertheless be employed with 
advantage. The mere evacuation of the fcecel contents of the 
bowels is not of so much importance in the cure of disease as is 
generally supposed. To restore healthy action in the bowels is 
the great object to be kept in view; and it is better that a patient 
submit to some unpleasant feelings from costiveness than to ha- 
rass his stomach and bowels by taking cathartics. 

When aliments leave the stomach, they pass quickly through 
the smatl intestines, a distance of about thirty feet in a liquid 
state, and when received into the large intestine are there retain- 
ed to undergo a kind of second digestion. Hence the seat of 



llsrjECTIONS OR ENEMAS. 437* 

costiveness in almost every instance is in the lower bowels, and 
within the reacli of the influence of injections. 

** Whatever is 2:ood to cure disease when taken into the sto- 
mach, is likewise good for the same purpose given by injection, 
as the grand object is to warm the bowels and remove canker. 
In all cases of dysentery, cold, piles, and other complaints, 
where the bowels are badly affected, injections should not be 
neglected. They are perfectly safe in ail cases, and better tliat 
they be used ten times when not needed than once neglected when 
they are. In many violent cases, jiarticularly where there is 
danger of mortification, patients may be relieved by administer- 
ing medicine in this way, when all other means would fail."— - 
l)r. Samuel Thomson. 

Lobelia administered by injection and retained, operates upon 
the general system, as effectually as when taken into the sto- 
mach. Indeed a greater degree of relaxation may be effected 
by the same quantity of lobelia administered by enemas than 
when taken into the stomach. Often I have observed a most 
striking change for the better produced in violent attacks of 
disease by a lobelia injection retained. Obstruction in the sys- 
tem, wherever situated, appears to be more effectually removed 
by relaxing the system with lobelia tlian by any other means. 
Not that we are to depend, however, upon this treatment, to the 
exclusion of the use of stimulants and the vapour bath. 

Of the various methods of preparing Injections; together with fur- 
ther remarks in relation to their practical application, 

Haifa pint of warm composition tea, adding a teaspoonful of 
green lobelia powder, forms a suitable injection for ordinary 
cases of disease, where the symptoms are not of a dangerous or 
violent character, nor the bowels badly disordered. 

The above preparation is also well suited to common cases of 
disease in infants and children. 

When there is reason to believe that the bowels are ^<^ canker- 
ed" or coated with thickeued tenacious secretions or a false mem- 
brane, as they are in dysentery, diarritcea, and in obstinate cases 
of disease of every description, the following form of injection 
will prove more effectual than the one before mentioned, namely: 

Haifa pint of bayberry or No. 3 tea. made \(ivy strong and 
after it is strained or settled and poured off, add a large tea- 
spoonful of the liquid of the third preparation of lobelia; or take 
a large tablespoonful of bayberiy powder, and a teaspoon even 
full of cayenne pepper, pour on half a pint of boiling water, and 
when it settles and is sufficiently cooled, pour off or strain the 
liquid, and add a teaspoonful of No. 6, and a teaspoonful of either 
brown or green lobelia powder. 



438 



INJECTIONS OR ENEMAS. 



In violent cases the quantity of third preparation or of the 
pepper and lobelia must be increased to double or treble or even 
to ten times the quantity above mentioned. Thus in malignant 
forms of disease as in what are termed typhus or congestive fe- 
vers, I have generally found it necessary to administer a large 
tablespoonful of the third preparation of lobelia at a time by in- 
jection, and frequently repeat it, and continue it several days, in 
order to sustain vital action, and prevent mortification. I have 
known patients to recover from malignant forms of disease 
chiefly I believe through the influence of powerful stimulating in- 
jections, administered every hour or two, and in this way con- 
tinued from one to four or five days. In some of these cases the 
sensibility of the bowels was so low that from four to six injec- 
tions would be retained, before an operation was effected or the 
bowels made sensible to the impression. 

Stupor, convulsions, suspended animation from drowning, the 
inhalation of carbonic acid gas, or from any other cause; palsy 
of the extremities, paralysis of the bladder, locked -jaw, and 
mental derangement, are, in general, more within the control of 
powerful stimulating injections than any other means. 

A disease often becomes chronic, in consequence of the mucous 
membrane of the stomach and bowels being coated with a false 
membrane. By observing the character of the evacuations from 
the bowels during the course of disease we perceive that about 
the time that a favourable crisis takes place there will be more 
or less of a skinny like substance escaping from the bowels and 
which had previously coated their mucous membrane. To re- 
move this substance from the lower bowels, (where it is chiefly 
situated) the use of injections are particularly indicated. Thus 
long standing cases of dyspepsia are cured by the removal of a 
false membrane from the stomach and bowels, by means of 
courses of medicine and taking freely of composition powder, or 
of bayberry and pepper, together with the daily use of an enema. 
Powerful purgative medicines though they may sometimes bring 
aw ay false membrane when not too firmly adherent, yet as they 
neitlier restore tlie lost functions of the bowels nor establish 
healthy secretions, the bowels will consequently become more 
*^ cankered" by the use of cathartics; whereas under Thomsonian 
treatment the same course of treatment that removes '' canker" 
restores the functions of the bowels, and promotes healthy secre- 
tions. 

In cases of obstinate costiveness and where the chief object is 
merely the evacuation of the bowels, the following will be found 
sometimes to answer a better purpose than those already men- 
tioned. 



INJECTIONS OE ENEMASr 43& 

A tablespooiiful of salt, 

Do. do. molasses, 
And a pint of warm water. 

This may be rendered more effectual by the addition of a tea- 
spoonful of the third preparation of lobelia, or of the lobelia pow- 
der. 

In bad cases of piles the powerful stimulating injections should 
not be employed except under some peculiar circumstances, for 
instance, in paralysis of the lower extremities or of the bladder, 
or rectum, suspended animation, or in cases of extreme prostra- 
tion from illness. When a patient is affected with piles, and or- 
dinary injections are found to make the piles worse, I have never 
found any plan of treatment more effectual than a strong tea of 
witch hazel, sumac berries, bayberry, or poplar bark, used by 
injection at bed-time and retained until morning. This dimin- 
ishes the piles, relieves the soreness of the parts, and generally 
procures a motion from the bowels in the morning. 

Immense benefit may very often be derived by placing the sys- 
tem under the influence of lobelia administered by injection and 
retained ten or fifteen minutes, and indeed no harm will arise 
from it even though it should remain in the bowels many hours. 
In all violent attacks of disease one of the most important indi- 
cations is to relax the system by lobelia either taken into the 
stomach or administered by injection in luke-warm water. If 
stimulants are employed in the injection the lobelia will pass 
off before the system will be effectually influenced by it. In vio- 
lent cases of croup besides giving lobelia by the mouth, a tea- 
spoonful of the powder in a tea cup full of luke-warm water 
should be administered by injection, and this repeated if the case 
prove obstinate of cure. In severe cases of scarlet fever attend- 
ed with an undue determination of blood to the head, and in fine 
whenever there is vehement fever attended by a hard and tense 
pulse injections of lobelia powder in luke warm water, by relax- 
ing the system will very greatly assist the efforts of the constitu- 
tion to overcome obstructions, and restore the functions of the 
bowels. 

The practice of placing the system under the influence of lo- 
belia administered by injection and retained is not to be confined 
exclusively to cases in which there is a high fever. Disease that 
has become seated, whether accompanied with fever or not, has 
often been removed by means of lobelia injections. 

Some months since a daughter of my brother was taken with 
a sore mouth of an extremely distressing character, and various 
kinds of remedies, together with the use of the steam bath and 
the usual stimulating injections having failed to effect a favour- 
able change in the symptoms, and the disease having continued 
nearly two weeks a lobelia injection was administered and re- 



440 IJ«-JECTIOI^^S OP^ ET^EMAS. 

tained, which relaxed the system very much, aroused a new ac- 
tion in the howels, occasioning considerable pain and distress for 
a time, but the symptoms of the sore mouth at once assumed a 
more favourable aspect, and in a short time it was well. 

Lobelia retained in the bowels will always produce for a time 
more or less pain and distress, by greatly increasing the sensi- 
bility of the parts, and as it were, attracting the nervous influ- 
ence to the bowels, removing obstructions, and restoring their 
lost functions. Patients may be effectually vomited by lobelia 
administered in the manner just described; the vomiting and re- 
laxation of the system even continuing longer than when an 
emetic is taken in the usual way. 

In children, except when the symptoms are of a violent cha- 
racter, the third or even the fourth of a teaspoonful of lobelia 
powder administered by injection may be found sufficient to pro- 
duce the desired eiFect upon the system- In a case of malignant 
scarlet fever in a child of Mr. John Lippincott of N. J., four 
large teaspoonsful of brown lobelia powder were administered by 
injection in bay berry tea, and retained from four o'clock P. M. 
until seven o'clock next morning, and during this period half a 
teaspoonful of the liquid of the third preparation of lobelia was 
given by the mouth every half hour. After this severe struggle 
of the constitution aided by medicine against the disease, the pa- 
tient began to mend and finally recovered, and doubtless by 
the energetic and persevering course of treatment instituted by 
Dr. Lee the attending physician in the case. 

In all cases of obstinate obstructions in a part, attended with 
violent pain and strong pulse, as in severe pleurisy, inflamma- 
tion of the brain, inflammation of the lungs, croup, &c. lobelia 
should be used freely, eitlier given by the moutli or administered 
by injection and retained. In some instances it will be neces- 
sary to repeat the injections at intervals of every four or five 
hours, with a view to overcome obstructions if there be seated in- 
flammation; to equalize the circulation of the blood and of nerv- 
ous power. In tliis way we obtain all tlie benefits that can pos- 
sibly result by relaxing the system by blood-letting, and with- 
out any danger of the serious consequences which not unfrequent- 
ly result from the loss of blood. 

Lobelia administered by injection exerts a more prompt and 
effective influence upon the kidneys, bladder and uterus, than 
when taken into the stomach. Hence in all cases of disease of 
any of these organs, or in parts within the vicinity of the lower 
bowels, the use of injections will constitute a very essential part 
of the treatment. 

Violent inflammation of the kidneys, strangulated hernia, in- 
flammation of the neck of the bladder, retention of urine, painful 
stricture of the urethra and inflammation of the uterus, demand 



ITfJECTIONS AXD ENEMAS. 441 

the prompt employment of lobelia injections, besides the usual 
constitutional treatment proper to be employed in such cases. 

Habitual costiveness is rarely cured by the use of ordinary in- 
jections alone; other means must be employed, as the circum- 
stances of the case require. Sometimes a free use of cayenne 
pepper at meals will restore the natural action of the bowels. 

In administering a course of medicine in deeply seated disease, 
no matter by what name it may be called, it is a good practice 
to administer a stimulating injection previously to the steaming, 
and after the bath repeat the injection composed simply of half a 
teaspoonful of lobelia powder in warm water, so that it may be 
retained, and then give the emetic of the third pi*eparation of lo- 
belia or some other preparation of lobelia combined w ith stimu- 
lants in bayberry tea. 

I attended a lady at Moores Town, N. J., who continued nine 
days without any motion from the bowels, notwithstanding in- 
jections were administered daily. She experienced no apparent 
inconvenience from the constipation of the bowels, and being in 
a state of extreme prostration, this patient would probably not 
have recovered if her stomach and bowels had been aggravated 
by cathartics, or even by laxatives, the mere stimulous of dis- 
tention arising from tlie presence of foecal matter in the bowels, 
assisting in supporting the strength of the patient. 



3 E 



C NTAINING 

A GENERAL DESCRIPTION 

or THE 

MEDICAL PROPERTIES AND USES 

OF THE 

VARIOUS MEBICIJVES JIJ^D COMPOUJ^DS 

EMPLOYED IN THE 



LOBELIA INFL ATA— EMETIC HERB. 

There are several species of lobelia, none of wliich, how- 
ever, except the injiata appears to possess medical properties of 
sufficient importance to entitle them to a place in the materia 
medica. The Lobelia injiata presents several peculiarities by 
which it may very readily be distinguished from every other 
plant. It grows in every kind of soil, but is to be found most 
plentifully in old pasture fields, and in fields that have been in 
grass a year. Lobelia does not come to maturity the first 
year of its growth. It is a biennial plant, rising but very little 
above the surface of the ground during the first summer, and on 
the following one it blossoms and seeds. The lobelia pods or cap- 
sules are very easily distinguished from those of any other plant. 

No one except Dr. Samuel Thomson has any just claims to 
the discovery of the medical virtues of lobelia. This like many 
of the most useful discoveries that have been made, was the re- 
sult of accident. Thomson during a period of twenty years, 
commencing with early boyhood, had often observed the singu- 



444 



MATERIA MEDIC A. 



lar effect of lobelia upon persons by chewing a small portion of 
the plant, before it occurred to him that it possessed any valua- 
ble medical properties. The small quantity generally taken, 
and the persons that took it being generally in good health, af- 
fords an explanation why the medical virtues of lobelia so long 
escaped the discriminating mind of Thomson after having wit- 
nessed its effects so often. The idea of its being useful as medi- 
cine originated from observing its powerful effects upon a man 
who had swallowed some lobelia without knowing what it was. 
The man became very much relaxed, vomited freely, sweat pro- 
fusely, and in a short time after ate a hearty dinner, and de- 
clared that he never had any thing to do him so much good. — 
This circumstance induced Samuel Thomson to make a trial of 
it for cleansing the stomach, which resulted in the conviction 
that it possessed important medical properties — that it was pow- 
erful in removing disease, and harmless to the system. 

"In giving a description of this valuable herb," (says Samuel 
Thomson) "1 shall be more particular, because it is the most 
important article made use of in my system of practice, without 
which it would be incomplete, and the medical virtues of which 
and the administering of it in cases of disease I claim as my own 
discovery. The first knowledge I ever had of it was obtained 
by accident ojore than forty years ago; and I never had any infor- 
mation whatever concerning it, except what I have gained by my 
own experience. A great deal has been said of late about this 
plant, both in favour and against its utility as a medicine; but 
all that the faculty have said or published concerning it, only 
shows their ignorance on the subject; for there is very little 
truth in what they have stated concerning its medical proper- 
ties, except wherein they have admitted it to be a cure for the 
asthma." 

The powerful effect produced upon the system by the use of 
lobelia, more especially where there is much disorder, has doubt- 
less induced many to believe that it is poisonous. The asser- 
tion, however, that lobelia is a poison is not true; " but on the 
contrary,/ as Dr. Tiiomson very justly observes, '^ there is no 
vegetable that the earth produces more harmless in its effects on 
the human system, and none more powerful in removing disease 
and promoting liealth." 

" I am confident" (observes Professor Tully, of Yale Col- 
lege) the old woman's stories in the books to the contrary not- 
withstanding, that lobelia is a valuable, a safe, and a sufficient- 
ly gentle article of medicine; and I think the time will come 
when it will he much better appreciated. Little, however, of its 
value can be specified within the compass of a single sheet of 
paper." 

The great majority of medical men have set their faces against 



MATERIA MEDICA. 445 

lobelia and the Thomsonian practice in general, with a degree 
of prejudice and stubbornness, which reflects no credit upon 
the profession. At the trial of Dr. Frost, of New York, and 
on other occasions where regular physicians have given testi- 
mony before "courts of justice," in relation to the properties 
of lobelia inflata, their evidence has been based upon the infor- 
mation they had obtained from medical authors who knew as lit- 
tle as themselves of its properties from experimental observa- 
tion. 

I have used lobelia extensively during nine years, most of this 
time having had a large practice, and I am fully confirmed in 
the belief that all that Samuel Thomson has said concerning the 
properties of lobelia is true. The longer I use it the more rea- 
son I have to prize it above all other medicines. This simple 
herb which may be found in every kind of soil, and on the top of 
hills and in valleys, contains medical properties not possessed 
probably by any other substance, either mineral or vegetable. 
The powerful influence it exerts on the system, and the many 
important indications which its use fulfils in the cure of disease, 
justly entitles it, in point of medical virtue, to be placed at the 
head of medical agents. 

Lobelia operates as a pure and powerful stimulant to the great 
sympathetic system of nerves, which control the functions of the 
stomach, bowels, and all the internal organs. Under its sti- 
mulating influence the stomach and bowels are made to feel their 
diseased condition, the vital powers are concentrated to the seat 
of disease, the restorative efforts of nature are called into action 
to expel disease, and during this conflict of the restorative ef- 
forts of nature against disease, patients frequently experience 
distress and pain in the stomach and bowels, the system becomes 
relaxed, to such a degree in some cases that the patient thinks 
he is going to die — a feeling persons often experience during 
sea-sickness. 

^' When this medicine is given to patients tiiat are in a de- 
cline, or are labouring under a disease of long standing, the 
symptoms indicating a crisis will not take place until they have 
been carried tiirough from three to eight courses of medicine; 
and the lower they have been the more alai nnng will be the 
symptoms. I have seen some who would lay and sob for two hours 
like a child that had been punished, not able to speak or to 
raise their hand to tlieir head, and the next day be about and 
soon get well. In cases v, here patients have taken considerable 
opium, and a course of medicine is administered, it will, during 
the operation, produce the same appearances and sym])toms that 
are produced by opium when first given; the opium having lain 
dormant is roused into action by the enlivening effects of the 
course of medicine, and they will be thrown into a senseless 



446 



MATERIA MEDICA. 



state; the whole system will be one complete mass of confusion, 
the patient tumbling in every direction; will require two or three 
persons to hold them in bed; they grow cold as though dying; 
remaining in this way from two to eight hours, and then awake 
like one from sleep after a good nights^ rest, and become entirely 
calm and sensible as though nothing had ailed them. It is sel- 
dom that they have more than one of these turns, as it is the last 
struggle of the disease, and they generally begin to recover from 
that time. I have been more particular in describing these ef- 
fects of lobelia in particular cases, where disease is deeply seat- 
ed, as they are very alarming to those unacquainted with them, 
in order to show that there is no danger to be apprehended as it 
is certain evidence of a favourable turn of the disease." — JDr. 
Thomson. 



Preparations of Lobelia. 

To prepare the green lobelia powder the herb should be gath- 
ered when in blossom; dry it in the shade, and as soon as it is 
thoroughly dried, strip or beat off the leaves and pods, reduce it 
to a fine powder, and keep it secluded from the air, dampness and 
from light. This iorms the green lobelia powder. This prepa- 
ration of lobelia is generally employed as an emetic in ordinary 
cases of disease, and for children in general. It is usually given 
in strong composition tea, or in a strong decoction of bayberry 
or sumac, adding a portion of cayenne or of No. 6. 

The green lobelia powder is not as efficient an emetic as lobe- 
lia seed pulverized, and therefore in severe cases the latter is to 
be preferred. In severe cases when it is proper to relax the 
system fully as in violent attacks of fever, pleurisy, inflammation 
of the lungs, violent pain, strangulated hernia, kc. the pulver- 
ized lobelia seed should be employed. General directions for 
preparing emetics will be found under the head of courses of 
medicine. 

2d. To prepare a tincture of lobelia take the freshly dried 
herb in any stage of its growth, before the leaves become yellow 
and put it in alcohol, whiskey, or in madeira or sherry wine — 
Tinctured in vinegar it is a worthless preparation. The tincture 
is a convenient form of administering lobelia to children as an 
expectorant in whooping cough, and affections of the breast in 
general. Ordinary attacks of croup may be cured by giving 
promptly and freely of the tincture of lobelia. As an emetic the 
lobelia powder or the third preparation is to be preferred to the 
tincture; but when it is desired to place the system under the 
influence of lobelia in a moderate way, as in cases of tight cough, 
disease of the chest in general, dyspepsia, palpitation of the 
heart, scrofula, and in fine, in a great variety of cases of disease, 



MATERIA MEDICA. 44T 

the use of the tincture of lobelia forms a very convenient and use- 
ful preparation, given to an extent to produce a slight degree 
of nausea. I have observed the use of the tincture of lobelia 
taken in doses of from half to a teaspoonful every hour or two, 
to be attended with very great benefit in very many cases of 
dyspepsia, consumption, and in diseases of the breast in general. 

Tincture of lobelia forms a substitute for the various kinds of 
anodynes in general use, such as Godfrey's Cordial, Para- 
goric and other preparations containing opium. Given to infants 
and children in small doses varying from five to tw enty drops, it 
quiets restlessness, and disposes to sleep. Administered in this 
way lobelia has a soothing influence upon the system. Lobelia 
is not narcotic, it possesses no such properties. 

Taken in small doses by those who are attending upon the 
sick the tincture of lobelia will be useful in protecting the sys- 
tem from disease. 

Lohelia Seed. — To obtain lobelia seed the herb should be col- 
lected when the pods have turned yellow. If left until the cap- 
sules are fully ripe and dried, the pods being open at the top 
the seed will fall out unless great care be taken in gathering. — . 
To prepare the seed for use, they must be finely pulverized in 
a mortar or by grinding. 

The lobelia seed exerts a much more powerful influence upon 
the system than the green pow^der, or the tincture. The alarm- 
ing symptoms as they are so called, are seldom produced by the 
use of any other preparation of lobelia than the seed. A free 
use of the brown lobelia will rarely fail of relaxing the system; 
and as this is a point of great importance in the cure of disease 
attended with high fever or violent pain, the brown lobelia pow- 
der should be employed, or at least a portion of it combined with 
the green powder. In cases of strangulated hernia; inflamma- 
tion of the kidneys, bladder, or uterus; peritoneal inflammation; 
stranguary; apoplexy; violent fever, such as often attends scar- 
let fever; severe cases of rheumatism; locked jaw; violent cramp 
in the stomach; severe cases of croup; St. Vitus' dance; palsy; 
painters' colic; severe forms of pleurisy and inflammation of the 
lungs; dropsy of the chest; and in bleeding from the lungs, ad- 
ministering a portion of brown lobelia powder by injection so as 
to be retained, constitutes a most important part of the treat- 
ment. We are not to depend however upon this alone. In treat- 
ing disease, in general there are several important objects to be 
kept in view in regulating the treatment. These are to restore 
the natural temperature of the blood; equalize the circulation; 
remove obstructions; excite vomiting; sustain the restorative ac- 
tions; promote perspiration, and other secretions; cleanse the 
stomach and bowels of "canker"; and assist digestion. The 
means and remedies to be employed to fulfil these indications, 



448 



MATERIA MEDICA. 



are — the vapour batli ; pure stimulants as capsicum, and com- 
sitioni lobelia emetics prepared as directed under the head of a 
course of medicine; broken doses of lobelia^ injections of lobelia 
retained; bayberry or other of the No. 3 or anti-canker medi- 
cine; and lastly, bitters. 

Third Freparation of Lobelia, 

Directions for Preparing. — Take an ounce of lobelia seed pul- 
verized; an ounce of cayenne pepper; and an even tablespoonful 
of nerve powder. Mix them together, and add between half a 
pint and a pint of No. 6. To be kept in vials or bottles tightly 
corked, and not allowed to remain in a hot place. This prepa- 
ration given in strong bayberry or No. 3 tea, forms an efficient 
emetic. It is a powerful agent for assisting nature to overcome 
disease, and may be used with perfect safety. The dose is from 
a teaspoonful to a tablespoonful, to be repeated as the circum- 
stances of the case may demand. I knew an instance where 
a child but nine months old, took three ounces of the third pre- 
paration of lobelia during one afternoon. It was a case of croup, 
which had continued two or three days, before this thorough 
treatment was adopted. The patient recovered through the 
agency of the treatment. 

The third preparation of lobelia is particularly adapted to 
violent attacks of disease, as in fits, bilious colic, cholera mor- 
bus, locked jaw, poisons taken into the stomach, suspended ani- 
mation from drowning, lightning, or from inlialing carbonic 
acid gas; difficult cases of croup, and astJima; gout, palsy, and 
in all cases of* violent pains and inflammation in the kidneys, 
bladder, &c. An effectual plan of treating violent attacks of 
disease is, to administer lobelia powder by injection to be re- 
tained, and giving the third preparation by the mouth. 

In preparing emetics for adults I generally combine the third 
preparation and lobelia powder. In all cases where the strength 
of the system is in a sunken condition, in protracted fevers, ma- 
lignant small pox, measles and scarlet fever, where the eruption 
is slow in appearing for want of vital action, or where there is a 
tendency to a retrocession or striking in of the eruption the use 
of the third preparation of lobelia is particularly indicated. 

In many cases, for instance in fevers where the patient is 
very low, the third preparation of lobelia may be taken in tea- 
spoonful doses repeated every hour or two and continued a day or 
even longer, without occasioning vomiting. If it should not 
cause vomiting, however, it need not occasion the least degree of 
anxiety, as it can do no harm under any circumstances. 

To sustain vital action, and prevent mortification in malig- 
nant forms of disease, for instance in the advanced stages of 



MATERIA MEDICA. 449 

what are called fevers, there are no means more eiTectual than 
the free use of the third preparation of lohelia in the stomach 
and administered by injection. The quantity to be used must be 
regulated by the effect pnKhiced. In some instances I have 
found it necessary to use a tablespoonful or more in an injection, 
and this repeated e\evy two or three hours and continued seve- 
ral days and nights in succession and with the most happy ef- 
fects, especially in low forms of fever. 

In treating of the third preparation of lobelia, Dr. Thomson 
observes. *'This preparation is for the most violent attacks of 
disease, such as locked jaw% bite of mad dog, drowned persons, 
fits, spasms ^nd in all cases of suspended animation, where the 
vital spark is nearly extinct. It will go through the system like 
electricity giving heat and life to every part. In cases where the 
spasms are so violent that the patient is stiff, and the jaws become 
set, by pouring some of this liquid into the mouth between the 
cheek and teeth, as soon as it reaches the glands at the root of the 
tongue the spasms will relax, andthe jaws will become loosened so 
that they will open; then give a dose of it, and soon as the spasms 
abate repeat it and afterwards give a tea of No. 3 for canker. — 
This course I never knew to fail of giving relief. It is good in 
less violent cases to bring out the measles and small pox." =^ ^ 
# # # # I have cured three dogs with this j)reparation, who 
WTre under the most violent symptoms of hydropliobia; and one 
of my agents cured a man wiih it who had been bitten by a mad 
dog; and I have not the least doubt of its being a specific for that 
disease." — Br, S, Thomson, 

I have never known of a patient being suffocated by having 
the third preparation of lobelia poured into the mouth, even 
where the patient was in a state of unconsciousness at the time. 

In giving the third preparation as an emetic and on ordinary 
occasions, it should be given in bay berry or No. 3 tea, made 
A^ery strong. 

Externally applied, the third preparation of lobelia, will 
prove beneficial in cases of rheumatism, lumbago, palsy, erysi- 
pelas, asthma, weakness of the spine, pain in the side, dropsi- 
cal swellings, chronic pleurisy, chilblain*, some species of tetter 
and in tic-doloureux. 

Covipound Lohelia Pills, 

Biredions for making. — Mix equal portions of puh erized lo- 
belia seed and cayenne pepper, and about one-fourth the quan- 
tity of finely pulverized gum arable; add sufficient water to form 
the mass into a projjer consistency to be formed into pills. 

The compound lobelia pills may be used as a general medi- 
cine where patients prefer taking them to liquicls. They arc 

S F 



450 



MATEKIA MEDICA. 



particularly adapted to cases of dropsy, as the desired im- 
pression may be made by medicine, without the use of liquids. 
Where a disease has become seated, as in dyspepsia, rheuma- 
tism, gout, asthma, tetter, scald-head, consumption, costiveness, 
jaundice, St. Yitus's dance, piles, palsy, neuralgia, scrofula, &c. 
these pills may be employed in tlie place of the stimulating teas; 
and as intermediate medicine where courses of medicine are 
given. The use of these pills will in many instances occasion 
more or less uneasiness and pain in the jjowels, until a more 
natural warmth and action are restored to the bowels, and then 
they will cease to produce pain unless taken in large quantities. 
The use of these pills promote tlie natural action of the bowels. 
They possess no cathartic properties. If tliere be a great ac- 
cumulation of acid in the bowels, a free use of these pills may 
cause the acid to be more sensibly felt, and produce purging. In 
the same way a dose of cathartic medicine may be made to ope- 
rate more quickly by increasing the sensibility of the mucous 
membrane of the bowels by stimulants. 

Bose.— In cases of rheumatism, dropsy, &c. when it is proper 
to place the system under the continued influence of medicine, 
from two to four pills may be taken about every two hours. In 
ordinary cases of dyspepsia and costiveness, from two to four or 
five of the pills may be taken at bed time. 



STIMULANTS 

Which raise and sustain vital action, and assist the ejforts of na- 
ture to remove disease. 

CAPSICUM—CAYENNE PEPPER. 

*< Numerous species of capsicum, inhabiting the East Indies 
and tropical America, are enumerated by botanists, the fruit of 
which differing simply in the degree of pungency, may be indis- 
criminately employed. The capsicum baccatum, or bird pepper, 
and the cR^sicum frutescens, are said to yield most of the cayenne 
pepper brought from the West Indies and South America; and 
Ainslie informs us that the latter is chiefly used in the East 
Indies. The species most extensively cultivated in Europe and 
this country, is that recognized as officinal by the pharmacop^es, 
namely: the capsicum annuum. The first two are shrubby 
plants, the last is annual and herbaceous."-— 17. S. JMspensa- 
tory. 



MATERIA MEDIC A. 451 

Capsicum is a pure and permanent stimulant, its direct effect 
upon the system, when taken, is to raise and support vital action, 
it restores a natural warmth to the system, increases the power 
of generating nervous influence, by which the secretions are in- 
creased, a determination to the surface is produced, and tlie circu- 
lation of the blood equalized. Cayenne pepper, therefore, is an 
important agent in the treatment of disease, always assisting 
nature and operating against disease, whether it be attended by 
chilliness or fever. It is as congenial to the living principle in 
man as the sun is to the life of the vegetable kingdom. 

The greater part of the cayenne pepper sold by grocers and 
apothecaries, contains very little strength, and therefore should 
not be used as medicine. 

The American pepper though inferior in strength to the im- 
ported, will answer in ordinary cases of disease provided it be 
properly dried and prepared. The African pepper however, 
is always to be preferred when it can be obtained pure. 

Large quantities of damaged capsicum are landed in our sea- 
port towns, so that the greatest degree of circumspection is ne- 
cessary in purchasing the article. Those who deal largely in 
Thomsonian medicines should either purchase the article in the 
pod so that they m.ay know its qualities and have it ground under 
their own inspection; or purchase it of those who are a judge of 
the article and have it ground in mills where no poisonous drugs 
are allowed to enter. 

*^I shall not" (says Dr. Thomson) undertake to dispute but 
that cayennehsid been used for medical purposes long before I had 
any knowledge of it; but it is equally true that the medical fa- 
culty never considered it of much value, and the people had no 
knowledge of it as a medicine, till I introduced it by making use 
of it in my practice. That it is one of the safest and best ar- 
ticles ever discovered for the removal of disease, I know to be a 
fact from long experience. Mention is made of cayenne in the 
Edinburgh Dispensatory, as chiefly employed for culinary pur- 
poses, but tliat of late it has been employed in the practice of 
medicine. The author says *' there can be little doubt that it 
furnishes one of the purest and strongest stimulants whicli can 
be introduced into the stomach; while at the same time it has 
nothing of the narcotic effects of ardent spirits. It is said to 
have been used with success in curing some cases of disease, 
that had resisted all other remedies.'^ ^*A11 this" (observes 
Thomson) *' I am satisfied is true, for if given as a medicine it 
will always be found useful; but all the knowledge they had of 
it seems to have been derived from a few experiments that had 
been made, without fixing upon any particular manner of pre- 
paring or administering it. # # ^ # # # # # ^ =^ 
*' When I first began to use this article" (says Thomson) it 



452 MATERIA MEDIC A. 

caused much talk among the people of Portsmouth and the adjoin- 
ing towns; the doctors tried to frighten them hy telling them that 
1 made use of cayenne pepper as a medicine, and that it would 
burn up the stomach and lungs as bad as viti'iol. The people 
generally, however, became convinced by using it, that all that 
the doctors said about it was false, and thus proved their ignorance 
of its medical virtues, and that in making these assertions they 
were influenced by a feeling of malice towards me. It soon came 
into general use, and the knowledge of its being useful in curing 
disease was spread all tlirough the country. I have made use of 
cayenne in all kinds of disease, and have given it to patients of 
all ages and under e\cry circumstance that has come under my 
practice; and can assure the public that it is perfectly harmless, 
never having known it to produce any bad effects whatever. It 
is doubtless the most powerful stimulant known, it is congenial 
with natuj'e, having a direct tendency to raise and maintain the 
natural heat of the system upon which life and health so materi- 
ally depend. It is extremely pungent and when taken sets the 
mouth as it were on lire; this lasts, however, but a few minutes, 
and I consider it essentially a benefit in many cases as it causes 
a free flow of saliva from the glands of the mouth and throat." 

An important object to be kept in view in the treatment of dis- 
ease ol every variety, and in every stage, is to assist the efforts 
of nature by tlie use of stimulants. And the use of cayenne pep- 
per, altliough not necessary in every case of disease, may still be 
given with safety under all circumstances. 

To one not fully acquainted with the effects of cayenne pepper 
upon the system, it may appear a strange practice to give the ar- 
ticle in cases of fever. Singular as it may seem, it is neverthe- 
less true, that excepting lobelia there is no other article of equal 
value with cayenne j)epper in the cure of fevers in general. As 
to the declarations of physicians that the use of cayenne inter- 
nally will aggravate fever, or that it will increase inflammation 
in the stomach and bowels, given even in large quantities, is 
contradicted by the experience and observation of thousands of 
men and women, possessed of as much common sense and as ca- 
pable of appreciating the effects of medicine as the medical pro- 
fession. 

Exj)erience has proved that cayenne pepper is the best re- 
medy known for inflammation of the throat; and where is the 
proof that it has not the same curative effect in inflammation of 
the stomach and bowels. Cayenne relieves inflammation of the 
stomach and bowels by exciting the secretions. 

As a general rule in disease, cayenne pepper or Thomson's 
composition, should be used until the disorder is broken up. 

In ordinary cases of colds, catarrh, mild cases of fever, recent 
attacks of dy spepsia? or almost any kind of ailment not too deep- 



MATERIA MEDIC A. 453 

ly seated, flie free use of cayenne pepper tea, together with par- 
ticular attention to diet, and avoiding exposure, will afford suf- 
ficient assistance to nature to remove the disease. 

The efficacy of a free use of cayenne pepper in promoting di- 
gestion, no one will jiretend to deny. Its use will be found bene- 
ficial even in those cases of indigestion or dyspepsia attended by 
extreme tenderness at the pit of the stomach. The best time to 
take cayenne in cases of dyspepsia is with food, or shortly after 
meals. 

In dysentery, where most medical men influenced by the doc- 
trines of the schools, consider the use of active stimulants \ery 
improper, yet even in the most inflammatory form of the disease 
cayenne pepper may be used not only with safety, but with 
especial benefit. Tiie use of cayenne pepper is particularly in- 
dicated in cases of dropsy, jaundice, long standing cases of tet- 
ter, costiveness, flatulency, rheumatism, and gout. In fine it 
may be used with perfect safety in all cases of disease. 

The utility of cayenne for the cure of scarlet fever and malig- 
nant sore throat is admitted even by the medical profession; and 
would they but try its efficacy in all other forms of fever, they 
would find it as beneficial as in scarlet fever, notwithstand- 
ing its use is contra-indicated by the popular, tliough false doc- 
trines propagated in the schools of medicine. I once heard 
professor Revere of Jefferson college observe, that almost every 
one knew cayenne pepper to be one of the best remedies for an 
inflamed throat, '* and it is impossible," said he, ** for us to ex- 
plain why it is not equally beneficial in inflammation of the sto- 
macli or bowels." 

Cayenne pepper applied to the'skin will produce redness and 
increase the heat of the part, and aggravate acute inflammation 
on the surface of the body; but when applied to a secreting sur- 
face, as the mucous membrane of the stomach or bowels, it pro- 
motes the secretions from these surfaces, and in tliis way re- 
lieves inflammation, and assists in bringing about a favourable 
termination to disease. Cases of chronic diarrhoea of long 
standing have been cured by using freely of cayenne pepper. 

The usual dose of cayenne is from a half to a teaspoonful. It 
is usually taken in the form of tea, made by pouring boiling wa- 
ter upon the powder. Sugar may be used freely in tjie tea. 

In certain conditions of the stomach, and more especially when 
it is empty, taking a dose of cayenne will occasion pain for a 
few minutes. The pain appears to arise in consequence of a 
sudden development or generation of gas or wind in the stomach, 
the pain subsiding as soon as wind is expelled. No harm^ is to 
be apprehended, however, from pain occasioned in this way, 
but on the contrary, we often find that patients experience a re- 



454 



MATERIA MEDIC A. 



markable change for the better immediately after experiencing 
a severe spell of pain from taking a dose of cayenne pepper. 
About four years ago I prescribed medicine to a man Avho had 
been dyspeptic, and otherwise in feeble health, for twenty years, 
and on taking the first dose of Thomsonian medicine, which con- 
sisted of a teacup half full of strong bayberry tea and a large 
teaspoonful of cayenne pepper, (instead of half a teaspoonful as 
I had directed) he was suddenly seized with violent pain in the 
stomach, a cold sweat broke out, and for some time he was help- 
less. After the pain had subsided, he fell asleep, slept several 
hours, and when he awoke declared tliat he had not felt so well 
at any time for many years. The patient continued the use of 
the medicine and his health was soon restored. 

When patients experience severe pain in the stomacli after tak- 
ing a dose of pepper, warm applications — a hot brick or flannel 
WTung out of hot water applied to the pit of the stomach will 
generally relieve the pain. Taking pepper tea in very small 
quantities frequently repeated will seldom occasion pain, even on 
an empty stomach. 

As a gargle in ulcerated sore throat there is no remedy in point 
of efficacy equal to cayenne pepper. A preparation of vinegar, 
salt and cayenne pepper has been a long time in high repute in 
some southern countries as a remedy for malignant. sore throat 
and scarlet fever. 

Tonics and other medicines are rendered more active and ef- 
ficient by being combined with a portion of cayenne. 

Cayenne pepper applied externally is very useful in many 
cases, as in rheumatism, dropsy, and in all cases where the use 
of external stimulants are indicated. Poultices of pepper may 
be employed witli great advantage in a great variety of cases, as 
in clironic rheumatism, cold abscess, white swellings, hip dis- 
ease, indolent ulcers, disease of the spine and in all cases when 
it is necessary to stimulate the vessels of a part by the direct 
application of a stimulant. 

THOMSON'S COMPOSITION POWDER. 



To make Composition Powder.— Take three pounds of finely 
prepared bayberry root bark, one and a half pounds of best gin- 
ger, three ounces of cayenne, and three ounces of cloves. All 
tliese are to be finely pulverized, and thoroughly mixed and pass- 
ed through a sieve. 

A variety of formulas for preparing composition powder have 
been published as an improvement ujion that of Thomson's. — 
Some recommend the addition of a large portion of butterfly 
root (asclepais tuberosa) others sassafras root; either of which 



MATERIA MEDICA. 455 

however, are comparatively useless articles, and when added to 
Thomson's composition powder they occupy the place of ar- 
ticles possessing properties of far greater efficacy in the cure of 
disease. 

The composition powder made of genuine articles is adapted 
to all cases of disease, and hence it forms a most important and 
useful medicine for general family use. 

The composition, besides its stimulating qualities, contains as- 
tringent or anti-canker properties. It may be used with safety 
in all cases of disease, and it is more employed by Thomsonians 
as a general medicine than any other article or compound. In- 
deed th@ composition is so universally applicable in the treat- 
ment of disease in general that an enumeration of the varieties of 
disease and ailments in which this medicine may be used with 
advantage would comprise a list of almost every form of disease 
to which the human system is subject. 

Dose- — The usual dose of composition powder is a teaspoonful' 
scalded in a teacup half or two-thirds full of boiling water, 
sweetened and drank warm. This is the proper mode of prepar- 
ing the composition wiien the patient is confined to the house, or 
going to bed; and when it is desired to produce perspiration. 

Tlie following is a better way of preparing the composition for 
persons exposed to the weather, namely: Take of composition 
powder and sugar each a teaspoonful, I'ub them together dampen- 
ed with a little water; t!ien add a teacup half full of luke-warm 
or cold water, stir it together well and take before it settles. 

A dose of composition sometimes occasions pain in the sto- 
mach, frequently nausea, and sometimes vomiting, more especi- 
ally in those ui^accustomed to its use, but never except the sto- 
mach be more or less disordered. 

In preparing composition, even for cliildren, it should be made 
strong and be well sweetened; a wineglassful of composition tea 
made strong, will in general prove more beneficiai to the patient 
than three times the quantity if made weak. 

GINGER. 

The ginger plant ^^ is a native of Hindostan, and is cultivated 
in all parts of India. It is also cultivated in the West Indies, 
whither it was transplanted from the East." — Z7. S, Bispen, 

The common ginger of the shops is obtained almost exclusive- 
ly from Calcutta. The best ginger comes from Jamaica, and 
is usually termed Jamaica ginger, or white ginger. The supe- 
riority of the Jamaica ginger arises from the manner in which it 
is dried. The best roots are selected, the skin taken oif, and 
then dried separately in the sun. The common ginger, as sold 



456 



MATERIA MEDIC A. 



by storekeepers and apothecaries is often deprived of almost all 
its strength by long keeping and altogether unfit for medical pur- 
poses. In making composition powder the Jamaica or white 
ginger should be used, unless the common ginger can be obtained 
fresh and of a good quality. 



Medical Froperties. — Ginger is a pure mild stimulant, and as 
such it may be employed in all cases of disease; its use can injure 
no one. Ginger tea forms a valuable medicine for infants and 
children. In fine it may be employed as a mild stimulant in all 
cases of disease. 

Ginger tea is much employed as a remedy for colic in infants. 
Its use promotes digestion and lessens the liability to colic. 

In mild cases of measles, scarlet fever, small-pox, and vario- 
loid, ginger tea, may be employed as a general stimulant. 

Combining ginger and cayenne in about equal portions forms 
a sufficiently active stimulous for general use in the treatment of 
disease. Tonics may be rendered more efficient and less unplea- 
sant to the taste by the addition of a portion of ginger. 



ASTRINGENTS AND DETERGENTS. 



{Thomsoii's '' JS*o. 3, or Medicine for Canker, ^^^ 

Stuange as it may appear, it is nevertheless true, that one 
of the most important indications for the cure of disease has been 
as yet overlooked by the medical profession, namely: the removal 
of morbid secretions from the mucous membrane of the stomach 
and bowels, by the use of astringents. Furtlier remarks in re- 
lation to the subject of morbid secretions may be found on pages 
6 and 411-12 of this work. 

The medical profession employ astringents, hut they are gene- 
rally of a directly binding nature and prescribed with the view 
only of constringing, or to give tone to textures that are in a re- 
laxed condition, as in chronic diarrhoea and passive hemorrhage. 

Dr. S. Thomson by a long course of experiments discovered 
a number of articles ^*good for canker" as he terms it, which 
may be taken freely without producing costiveness. Bayberry, 
upland sumac, white pond lily, and wihl raspberry leaves, are 
the articles principally employed for cleansing the stomach and 
bowels of morbid secretions or ** canker," and to overcome their 
tendency to putrefaction. 



MATEniA MEDIGA. 45T 

BAYBERRY. 

{yMijrica Cirefera. ) 

Of the articies raentionetl unCier the ]iea<l of astringents, the 
bark of bayberry root is the best adapted to general use as an 
internal reniedy. 

Bay berry root hark shouM be collected in the fall after the 
commencement of frost, or early in the spring before tlie leaves 
put forth. Bayberry is a very important article in the Thomso- 
iiian j)ractice, and great care should be taken to obtain that 
which is good. There are large quantities of bayberry sold 
that have been collected in an improper season, mixed with other 
bark, and mouldy, and consequently possesses but little, if any, 
medical virtue. Composition powder made of such bayberry as 
above mentioned, old and worm eaten ginger root, and damaged 
pepper, w^ould ])rove a useless medicine; whereas wdien pre- 
pared of good materials, it constitutes one of the most valuable 
medicines ever compounded. 

I have myself seen in the w^arehouses of wholesale druggists, 
large quantities of bayberry bark, that had been purchased at a 
very low price, but it was wholly unfit for medicine, a consider- 
able portion of it being in a state of decay. 

The best bayberry is found in a sandy soil, and near the sea. 
The principal Thomsonian store in Philadelpltia is supplied with 
bayberry from the coast of New Jersey, where it is collected in 
the proper season. 

To prepare for taking. — Bayberry and all other astringent 
articles, are usually taken in the form of decoction. Bayberry 
tea to be effectual, should be made strong by steeping the bark, 
either pulverized or unpulverized in boiling water. Two large 
teaspoonsful of pulverized bayberry powder to a teacup two- 
thii'ds full of boiling water will form a tea of the proper strength 
to answer the purj)ose for which it is generally given. 

Astringent teas should never he made in an iron vessel. 

A strong tea of bayberry, adding a ])ortion of cayenne, con- 
stitutes an important medicine in the cure of disease in general. 
This pre])aration though not so much used as the composition 
powder, is yet more effectual in cleansing the stomach and bow- 
els of "cft/i/t"er." A teacupful of strong bayberry tea taken 
when the stomach is foul, will sometimes cause vomiting, but 
never unless the stomacli be disordered. 

As a preventive to disease in general there is probably nothing 
better tliat can be taken than an occasional dose of bayberry and 
cayenne. 

5 G 



458 



MATERIA MEDICA. 



The most hnportaiit indications for the cure of disease, name- 
ly: to "support the internal heat and to overcome canker,'* 
are fulfiled by the use of bayberry and cayenne. 

An emetic of lobelia prepared in a strong tea of bayberry or 
sumac, will operate more effectually, and at the same time occa- 
sion less sickness than when given in pennyroyal tea, or luke- 
warm water. 

UPLAND SUMAC. 

(^Rhus Glabrum,) 

The bark, leaves, and berries of sumac are employed for me- 
dical purposes, and next to bayberry are the best remedy for 
cleansing the stomach and bowels of ** canker." There are 
three species of the sumac, eacli of which possesses similar pro- 
perties, and may be used for the same purposes. The species 
above named is most used. One species (rhus copallinum) is 
called dwarf sumac, scarcely ever reaching the height of six 
feet, and is found in dry rocky ground. A strong decoction of 
the bark of the root of the dwarf sumac is employed as a sove- 
reign remedy for venereal diseases by the Chippewa Indians. 

The leaves of the sumac should be collected in the autumn be- 
fore they are bitten by frost, and when fully dried, should be 
packed away and kept secluded from the air. 

Sumac Berries should be collected soon after the first hard 
frost. The dust or powder that coats the berry is the part em- 
ployed for medical purposes. Dr. A. C. Logan who has col- 
lected and prepared large quantities of this article, has the ber- 
ries thoroughly dried in an oven, and then rubbed over a sieve, 
by which process the powder is rubbed off and separated from 
the seed. This powder, generally called sumac dust, is used 
for cankered sore mouth, and when combined with bayberry pow- 
der in the proportion of one ounce of the sumac to four ounces 
of bayberry, forms a better anti-canker medicine than the bay- 
berry alone. This compound I have used of latter years as a 
substitute for the compound which Dr. Thomson calls No. 3, 
and where I have mentioned No. 3 powder in the practice, it is 
this compound that has been alluded to. The powder from su- 
mac berries and No. 6, mixed together, form a valuable remedy 
for tetter and ringworm; and also a wash in cases of indo- 
lent ulcers and cankered sore mouth. 



Sumac Bark should be collected when the leaves are off, or 
after they have commenced falling. A strong decoction made 



MATERIA MEDICA. 459 

of the harkf of of the bark, leaves and berries combined, may be 
used with advantage in affections of the kidneys, and in all cases 
of weakness of the uterine organs. 

"The gum which exudes from the bark on being punctured, 
during the summer, is beneficial in gleets and obstruction of the 
urine." — Mattson^s American Vegetable Practice, 

WHITE POND LILY. 

{JS-ijmphia Odorata.) 

White pond lily grows in ponds and ditches and is readily 
distinguished by its beautiful white flower. The root of the 
pond lily possesses astringent qualities, and may be employed 
in combination with, or as a substitute for bayberry and sumac 
when the latter cannot be obtained. The difficulty of collecting 
and preserving this root, and the fact of its being inferior to 
bayberry or sumac in point of medical virtue, has occasioned it 
to be almost abandoned except in making poultices. 

The pond lily roots should be collected in autumn or very 
early in the spring? washed clean, cut into strips and strung 
upon thread to dry. 

WILD RED RASPBERRY. 

{Ruhis Strigosis.) 

This shrub grows in greet abundance in New England, and 
also in some southern sections of this country. 

The leaves, which are the only part employed for medical 
purposes, are a mild astringent, and so agreeable to the taste 
that many families use it as a substitute for imported tea. 

A strong tea of raspberry leaves is a useful remedy for ordi- 
nary bowel complaints of infants and children. To be efficient, 
however, it should be made strong. In treating of this article 
Dr. Thomson observes: "it is the best thing for women in tra- 
vail of any article I know of" He recommends a strong tea of 
it to be given, sweetened, adding a portion of cayenne. A tea 
of the raspberry leaf, adding milk and sugar, is good for infants, 
and Dr. Thomson asserts that it will prevent sore mouth. 

WITCH HAZLE. 

{Hamamelis Virginica,) 

The leaves of tlie witch hazle furnish an active astringent, 
and a strong decoction of this article may be used with much 



460 



MlTr.MA MEDIC A. 



benefit as an injection in piles, prolapsus uteri, and in com- 
plaints peculiar to females. 

The leaves should be collected in tlie autumn before they are 
injured by the frost, dried out of the sunshine, and as soon as 
dry they should be either pulverized or packed in a box and 
secured from the air. Witch hazle is of too binding a nature to 
be taken in ordinary cases witliout a portion of cayenne being 
added. When used as an injection in female compiaiiits a small 
portion of cayenne should be scalded with the leaves. 



EVAN ROOT. 
(Geum Ilirale.y 

This plant is peculiar to low marshy ground, and has re- 
ceived a variety of names, viz: chocolate root, water avens, 
throat root, pyrpie avens. It possesses slightly astringent and 
tonic properties, and may be used witli benefit in diarrhea, dy- 
sentery, and in bowel complaints in general. 

MARSH ROSEMARY. 
(^Statia Limonium.) 

This plant, the root of which is used for medical purposes, is 
found only in salt marshes. 

The root of marsh rosemary is a powerful astringent, and is 
cliielly employed as a remedy for sore mouth and throat. The 
powdered root has a good effect upon old sores, tlie powder be- 
ing put dry into the sore, and a poultice or salve, applied. In 
long standing cases of piles, where the rectum is in a \ety re- 
laxed condition, or in lluor albus or whites, when a powerful 
astringent is required, a ])ortion of marsh rosemary added to 
witch hazle, or sumac, will form a better injection than either 
of the latter articles alone. 

The marsh rosemary is not taken internally on account of its 
binding nature. 

DEW BERRY., 



(Rubus Frocumhens.) 

Ths root of the dew berry and also that of tlie black berry 
plant, may be used as a substitute for baybcrry, or sumac, in 
dygentery and in bo^^cl complaints iji general. 



MATERIA MEDICA. 461 

CROW-FOOT— CRANES BILL. 

(^Geranium Maculatum*^ 

This plant may be found in many sections of this country. 
The root possesses actively astringent qualities. A decoction of 
this root has been used by injection with benefit in long standing 
venereal disease and fluor alhus. The root boiled in milk is a good 
remedy in bowel complaints of children, more especially when 
the disease has continued several days, and the patient's tongue 
not dry, and there be absence of fever. 

BEACH-DROP. 

(^Orbanche Virginiana,') 

A decoction of the root of the beach-drop may be employed 
for the same purposes as that of the crow-foot. The powdered 
root is a good application in cases of open cancer and indolent 
ulcers. 

The powdered root of the beach-drop, crow-foot, or marsh 
rosemary, stewed in fresh tallow, may be employed as an oint- 
ment for external piles and eruptions on the skin. 



TONICS— BITTERS. 

To strengthen the system and promote digestion. 

The use of bitters are particularly indicated in the latter 
stages of acute disease, when fever has subsided and the tongue 
is cleaning; and in all cases where the system is left in a relaxed 
condition, with feeble digestion after a disease has been broken 
up. In the suppurative stage of small-pox, and in cases of large 
abscesses that are secreting matter freely, bitters should be em- 
ployed, in combination with pwe stimulants, with a view to 
promote digestion and furnish the system with the necessary 
strength to carry on her healing operations. In chronic disease 
in general, bitters may be employed indiscriminately, provided 
the surface be moist and the patient clear of fever. 

The vegetable kingdom furnishes a great variety of bitter 
tonics, of which those mentioned under this head are believed to 
be the best, and sufficient to fulfil the indications in which tonics 
are employed. 



462 



MATEHIA MEDICA. 



The chief objection to the use of bitters during the active stage 
of disease is on account of their tendency under these circum- 
stances to dry up the secretions. 

PERUVIAN BARK. 



(^Cinchona Officinalis.) 

The genuine Peruvian bark is one of the most effectual tonics 
ever employed for the cure of intermitting fever or ague. It may 
be used as a general tonic in all cases where the use of this class 
of medicines is indicated. As a general rule powerful tonics 
should not be employed in the first stage of disease attended with 
fever and a dry coated tongue. Under these circumstances bit- 
ters unless combined with a large portion of cayenne, would re- 
press ratlier than promote the secretions, and aggravate the dis- 
ease. When by the free use of cayenne and otiier appropriate 
remedies the secretions are restored, the tongue cleaning and the 
skin warm and disposed to perspiration, then Peruvian bark or 
other tonics may be employed with advantage. 

Peruvian bark is rendered more efficient as a tonic by com- 
bining with it Virginia snake root, cloves and cayenne pepper. 
I frequently mix equal parts of Peruvian bark and spice bitters, 
and have always found it a good preparation. 

A tea made of equal parts of Peruvian bark and liquorice root 
is a good remedy for colic in infants, more especially where the 
spells of colic are observed to come on periodically. 

The title Jesuifs bark has been applied to the Peruvian bark, 
from the circumstance of the Jesuits having had tlie ciiief con- 
trol of the sale of the article during its first introduction into use 
in Europe about the year 1640. 

There are three species of Peruvian bark imported to this 
country, the pale, yellow and red. At one time the red bark was 
esteemed the most valuable. This induced druggists to convert 
other species into red bark by adulterations which so materially 
lessened the efficacy of the bark, that at one period the red 
bark was little used. Each species of bark above mentioned is 
efficient as a tonic, provided it be free from adulterations. 

Peruvian bark is most active when taken in substance, mixed 
with some liquid, as a tea of spice bitters, Virginia snake root, a 
solution of liquorice, or simply w^ith water. The unpleasant 
taste of the bark will scarcely be perceived when it is taken in a 
solution of liquorice. 

When the bark cannot be taken in substance its virtues may 
be extracted by boiling water, and taken in decoction. A small 
portion of orange peel, liquorice root, or spice, added, will im- 
prove the flavour of the tea; and where there is acidity of thesto- 



MATERIA MEDICA. 46S 

macli a portion of the sup. carbonate of soda, or salseratus should 
be added. 

Peruvian bark is often taken in wine, and with the most 
haj)py effects in many instances, as in recovery from disease 
where the strength of the patient has been very much exhausted. 

Bose. — The quantity of bark taken at a time varies from that 
of a teaspoonful to an ounce. Whilst some recommend it in 
small doses repeated every hour or two, others direct an ounce to 
be taken at once. More especially is it recommended to be ta- 
ken in large doses, in cases of intermitting fever where by a 
proper course of treatment the system is placed in a condition 
that warrants the free use of tonics. 

When Peruvian bark or quinine is used, all astringent me- 
dicines, viz: bayberry, sumac, No. 3, pills, &c. must be laid 
aside at the time, as the tanin and gallic acid in the astringents, 
form an insoluble compound with the active principle of the bark, 
rendering it inert. Astringents may be used in the forenoon 
and barks in the afternoon, or vice versa. 

Three important indications in the treatment of disease are: 
1st. To restore the natural warmth of the system. 2d. To 
cleanse the stomach and bowels of *^ canker," or morbid secre- 
tions; and Sd. To restore digestion. The first requires the use 
of pure stimulants, and sometimes the application of the vapour 
bath; the second, the use of astringents and detergents; and 
the third, tonics. Hence the general indication for the use of 
tonics is when the secretions are restored and the stomach and 
bowels cleansed of ** canker." 

QUININE. 

Quinine is the active principle of Peruvian bark, and may be 
used as a substitute for the bark. Quinine has sometimes been 
discovered to be adulterated with starch, stearin, sulphate of 
lime and sugar. There are means, however, of detecting adul- 
terations in quinine, for a knowledge of which the reader is re- 
ferred to the U. S. Dispensatory. 

Quinine is usually taken in the form of pills. Eight quinine 
pills of the usual size are supposed to be equivalent to an ounce 
of Peruvian bark. A pill to contain a grain of quinine, (equal 
to a drachm of bark) must be considered larger than pills are 
generally made. 

It is believed that quinine is rendered more active by the ad- 
dition of cayenne pepper. 

As a cure for intermittent and other forms of fever, when the 
condition of the system is favourable for the exhibition of tonics, 
there is probably no remedy of equal value with quinine. This 



464 



MATERIA MEDICA. 



medicine, however, is so easily taken, that it may be used too 
indiscriminately. It may be continued until large quantities 
have been taken, the system at the same time not being in a 
condition to be benefitted by its use. 

WHITE ASPEN AND BLACK ASPEN POPLAR. 

(^Popidus Tremnloides and Fopulus Grandidentata,^ 

The bark of these species of poplar possesses valuable tonic 
properties. Poplar bark constitutes an important part of the 
spice bitters. A very strong decoction of poplar bark may be 
employed as a tonic in any case where a tonic is needed. 

The white aspen is not so bitter as the other species, and may 
be very readily given to children. It is well adapted to cases 
when the bowels are left in a weak and relaxed condition after 
dysentery, diarrhoea, &c. 

In treating of the poplar Dr. Thomson says: <* The inner bark 
made in tea is one of the best articles to regulate the bile and re- 
store the digestive powers, of any tiling I have ever used. The 
bark may be taken from the body of the tree or from the limbs, 
or the roots, and the outside shaved off and preserve the inner 
bark, which should be dried and carefully preserved for use." 

Poplar growing in low ground is said to have stronger quali- 
ties than that which grows on dry soil. 

BALMONY. 

(^Chelone Glabra.) 

This herb, commonly called snake head, is found in low 
marshy ground and along the sides of brooks and ponds. 

Balmony is a strong bitter and may be employed as a general 
tonic, either singly or in combination with other bitters. The 
leaves stems and flowers are the parts employed. The herb 
should be collected when in blossom. 

BARBERRY. 



(Berberies Vulgaris.) 

The bark of every portion of this shrub possesses tonic 
powers, and it is a good article to restore digestion. Barberry, 
balmony and poplar hark finely pulverized and mixed together 
in equal proportions constitute Dr. Thomson's No. 4 bitters. — 
This is a valuable compound and may be employed in all cases 
where a strong tonic is required. 



MATERIA MEDICA. 465 

GOLDEN SEAL. 

{Hydrastis Canadensis*^ 

This plant which has received a variety of names, as Ohio 
kerkuma, yellow poccoon, and turmerie root, is highly esteemed 
as a tonic hy some Thomsonians. The root is the part used, 
which should be collected in the fall, well dried and reduced to 
powder. 

Golden seal is found in great abundance in Ohio and Indiana, 
and it is from thence that the principle supply is obtained. 

The usual dose is a teaspoonful of the powder, taken in warm 
water, or steeped in boiling water, and the tea only used. 

VIRGINIzl SNAKE ROOT. 

(^Serpentaria Virginiana,') 

This plant, the root of which contains both tonic and stimu- 
lant properties, grows ]dentifiilly in many sections of the United 
States, and it is said to be a native of this country exclusively. 

The Virginia snake root may be employed with benefit in fe- 
vers and in a variety of forms of disease, when the usual bitter 
tonics irritate the stomach. 

The usual dose of the powdered root is a;teaspoonful. To 
maketiie infusion pour a pint of boiling water on half an ounce 
of the root, and let it steep in a covered vessel; boiling the root 
dissipates its medicinal properties. 

CENTUARY. 

{Chironia Angularis.) 

*' Of the centuary we have the above species, wMiich is not in- 
ferior to the European. It is a beautiful annual plant, growing 
abundantly in the middle and southern states, and every part 
of it is medicinal, though the flowers possess the most efficacy. 
It is a pure bitter, witii some little aromatic flavour, neither un- 
pleasant to the taste nor offensive to the stomach; and is resorted 
to by every dcsciiption of practitioners, regular and irregular, 
in our intermittent and remittent fevers. Like some other arti- 
cles, it has an advantage over the Peruvian bark, of being sus- 
ceptible of employment in every stage of these diseases. The 
usual mode of prescribing it is by strong infusion, which is di- 
rected to be taken without much limitation." — Chapman, 

3 H 



466 



MATERIA MEDICA. 



RED DOG-WOOD— RED WILLOW. 

(^Cornus Sericea.) 

"This species of cornus is usually six or eight feet in beiglit? 
with numerous erect stems, which are covered with a shining 
reddish hark, and send out opposite spreading brandies. Tlte 
leaves are opposite, petiolate, ovate, pointed, entire, and on tlje 
under surface covered with soft brownish hairs. Tlie flowers 
are small, white, ancf disposed in terminal cymes, which are 
depressed and woolly. The fruit consists of globular, berry 
formed drupes, of a cerulean blue colour, and collected in 
bunches. — U. 8. Bysp, 

The red dog-wood is found growing in low wet lands, and 
along streams in almost every section of the United States. — 
The bark of this shrub contains valuable tonic properties, and 
many experienced practitioners assert it to be equal in efficacy 
to the Peruvian bark, and it may be employed as a substitute 
for the latter article. Growing in our own country it can be 
obtained genuine, whereas a great portion of bark imported as 
Peruvian, is a spurious article, containing little or none of the 
medical properties of Peruvian bark. 

WILD CHERRY. 



(Primus Virginiana.) 

Tub bark of this tree has tonic and astringent properties. 
As a tonic it is inferior in efficacy to either the red dog-wood, or 
Peruvian bark. It is adapted to cases of consumption, hec- 
tic fever and scrofula, and in chronic bowel complaints. It 
yields its properties to alcohol, and to hot and cold water. Boil- 
ing the bark destroys its medicinal powers. 

QUASSIA. 

This tree, the wood of which contains tlie bitter principle as 
it were in a concentrated form, is a native of Surinam, Jamaica, 
and the Cai'ibbean islands. 

This medicine was first introduced into use by a West India 
negro named Quassia, who employed it as a secret remedy, wiich 
proved successful in the cure of the malignant fevers of that 
country. The secret was ** disclosed to a Mr. Rolander, a 
Swede. Specimens were taken to Stockholm by this gentleman 
in the year 1756, and the medicine soon became popular in Eu- 



MATERIA MEDICA. 467 

rope. The name of the negro has been perpetuated in the gene- 
ric title of the plant." 

Quassia may be employed as a tonic in cases of general de- 
bility. It is usually prepared in infusion in combination with 
other tonics, columbo, gentian, Virginia snake root, and orange 
peel. 

Tonics are found to be more effectual by occasionally substi- 
tuting one article for another, or by frequently changing the 
compound. 

TULIP POPLAR. 

{Liriodendron Tulipifera.) 

The bark of this tree may be employed as a tonic, though it 
is inferior in point of efficacy to the aspen poplar. 

COLUMBA. 

CoLUMBA root possesses considerable power as a tonic, and 
as such may be used either alone or in combination with other 
tonics. 

THOROUGH-WORT— BONESETT. 

{Eiipatormm FerfoliatumJ) 

A warm infusion or a decoction of this plant will operate as a 
uauseant and emetic; when taken cold it acts as a tonic only. 

Bonesett has been extensively employed of late years in the 
treatment of intermittent, and remitting fevers. It is employed 
as a diaphoretic, emetic, and tonic. 

CHAMOMILE. 

(Jnthemis JVohilis.) 

Chamomile furnishes an agreeable and valuable tonic. It 
has been a long time employed as a medicine. A warm infusion 
of chamomile is often employed in domestic practice to excite 
perspiration in case of colds. A strong tea of chamomile drank 
warm will sometimes operate as an emetic. As a tonic or sto- 
machic, the cold infusion is usually employed. 

MYRRH. 
Gum mtrbh exudes from the body of a small tree grow- 



468 



MATERIA MEDICA. 



ing in Arabia, Felix and Abyssinia, called Balsamodendron 
myrrha. As the juice exudes it hardens and adheres to the 
bark. 

Two varieties of myrrh are distinguished in the market — the 
India and the Turkey myrrh — the former imported from the East 
Indies, the latter from the Levant. It is said that the India 
myrrh is collected in Abyssinia, and thence taken to the ports 
of Hindostan, while that which goes under the name of Turkey 
myrrh, is brought from Arabia by the route of Egypt." — U. S, 
JJysp. 

There is a great difference in the quality of myrrh. That 
which comes from Turkey is of a brighter colour, and more free 
from impurities than the East India myrrh. *^ When of good 
quality it is reddish-yellow, and translucent ; of a strong pecu- 
liar and somewhat fragrant odour, and a bitter aromatic taste. 
It is brittle and pulverizable, presenting when broken, a shining 
surface, which in the larger masses is very irregular." 

Myrrh is actively tonic, somewhat stimulant, and possesses 
in a high degree antiseptic properties. It constitutes the most 
essential ingredient in Thomson's No. 6, or rheumatic drops — 
one of the most valuable preparations, as a general family me- 
dicine ever introduced into use. 

Myrrh has been employed with much benefit in chronic diar- 
rhcea, and diseases of the lungs or chest, attended with a free ex- 
pectoration and general debility. Its use is also well adapted 
to female complaints, when unattended by fever. 

Myrrh may betaken in the form of pills, infusion, tincture, 
or the powder may be taken suspended in a liquid. 

To make Myrrh Pills — Take a table spoonful of finely pulve- 
rized myrrh, and of pulverized gum Arabic and loaf-sugar, 
each a large teaspoonful. Rub these up with a quantity of water 
sufficient to form a paste, and make into pills. 

To make an Infusion of Myrrh. — Steep an even teaspoonful of 
pulverized myrrh in a teacuj) of boiling water, find add a large 
teaspoonful of sugar, and a small portion of cinnamon. 

To make a tincture of Myrrh. — Put three ounces of powdered 
myrrh, and a quart of alcohol, or fourth proof brandy, into a 
stone jug and boil half an hour in a kettle of water, or let it ma- 
cerate several days in a warm place. 

T'o prepare the Powder for taking. — Rub together half a tea- 
spoonful of myrrh and a teaspoonful of sugar, then add a teacup 
half full of luke-warm water, or a tea of cinnamon or liquorice 
root, stir the mixture ;, and take before it settles. 



MATERIA MEDIC A. 469 

"When myrrh is taken in the form of pills or powder; care 
should be observed to select that of the best quality. 

Myrrh prepared in either of the forms above mentioned, is 
applicable to cases of general debility, accompanied by a relaxed 
condition of the bowels, and an absence of fever. Dr. S. 
Thomson informs us, that he has discovered it to be a valuable 
remedy in what are called worm complaints in children. 

The efficacy of Thomson's No. 6, and third preparation of 
lobelia, in preventing mortification in disease of a malignant or 
putrid tendency, may be partly at least attributed to the myrrh 
contained in these preparations. 

Applied to fresh wounds the tincture of myrrh excites 
healing action and lessens the liability to the occurrence of un- 
healthy inflammation. It is also a useful application in old sores, 
ulcerated sore throat, running from the ears, aphthous sore 
mouth, spongy gums, sore nipples, &c. The tincture of myrrh 
is also employed to promote the exfoliation of bones. In sinuous 
ulcers, and cavities that continue to discharge matter in conse- 
quence of a debilitated .state of the vessels of the part, tincture 
of myrrh injected into the cavity repeated daily will seldom 
fail of establishing the inflammatory action necessary to the 
production of granulations and a union of the sides of the cavity, 
Where the parts are too sensitive to admit the tincture to be used 
undiluted it may be combined with water or Bayberry tea. 
In cases of scrofulous ulcers, white swellings, hip disease, and 
wherever there is a free discharge of matter from a part, and 
the system is in a relaxed condition the internal use of myrrh 
will prove especially beneficial. 

After a vapour bath and the patient is rubbed dry, washing the 
surface with tincture of myrrh, affords a means of protection 
against cold, and strengthens and improves the condition of the 
skin. This practice is especially useful in cases where the skin 
is relaxed, and the patient feeble, as in chronic bronchitis, con- 
sumption, chronic pleurisy, asthma, dropsy, chronic rheumatism, 
chronic diarrhcea, marasmus, and in every other form of dis- 
ease attended by general debility. 

Thomson- s JVb. 6 or Rheumatic Brops, 

To this compound a variety of additions have been made by 
different individuals as an improvement upon Dr. Thomson's 
preparation. The value of this preparation as a medicine de- 
pends chiefly upon the myrrh which it contains, and no article 
can be substituted that will prove more beneficial than myrrh 
for the purposes to which the No. 6 is generally applied. 

To prepare •A'b. 6.— Take one ounce of peach-meats pounded, 



470 



MATERIA MEDICA. 



an ounce of African pepper, one pound of powdered myrrh, 
and a gallon of fourtli proof brandy. Put these into a stone jug, 
and boil it half an hour in a kettle of water, the jug to be un- 
corked. 

This preparation is employed as a general family medicine by 
Thomsonians. It is an excellent tonic and particularly useful, 
taken immediately after meals, to remove or prevent flatulency, 
and relieve oppression of the stomach. Ordinary colic may be 
speedily cured by taking freely of the No. 6. It is an effectual 
cure for ordinary colds provided the patient avoid exposure, and 
improper articles of diet. Sickness at the stomach, and even 
severe spells of sick head-ach will be relieved and frequently 
cured by a free use of No. 6, together with warm applications 
to the feet to favour perspiration. It also constitutes a valuable 
remedy for bowel complaints in general. Taken after meals it 
will prove a preventive against the sunjmer comjilaint. 

In deeply seated colds attended by a free ex])cctoration of a 
thick yellowish secretion, the use of No. 6 will be found benefi- 
cial. Truly there is scarcely an ailment, in which this prepara- 
tion may not be used with benefit, except wiien the secretions 
are suspended, as in violent ie\Qv atten<kMl by a dry tougue. In 
th? latter stages of disease, the No. 6 may be emjiloyed as a re- 
storative, and when there is a tendency to putrefaction, its use is 
almost indispensable to the recovery of the patient. 

As an external application No. 6 has been found useful in 
rheumatism, neuralgia, nightsweats, dropsy, consumption, and 
in all cases when the skin is in a relaxed condition. It may al- 
so be employed to great advantage in sprains, bruises, fresh cuts, 
indolent ulcers, putrid sore throat, sloughing ulcers, gangrene, 
and as a preventive to mortification both internally and exter- 
nally. 

JVo. 5 Syrup or Restorative Cordial, 

Take of white and black aspen poplar each half a pound, bark 
of the root of Barberry one pound, and boil them a few minutes 
in two gallons of water, then strain and add seven pounds of 
good sugar, and simmer until the sugar is dissolved, then skim 
it and add half a pound of finely powdered peach meats, and 
three quarts of good brandy- 
Dose— -Half a wineglassful three or four times a day. 

This syrup is useful in cases of recovery from sickness attend- 
ed with a weak and relaxed condition of the bowels. 

Another method of preparing a restorative cordial is to em- 
ploy the tincture of myrrh in place of the brandy. 



MATEHIA MEDIC Ac 471 

This last preparation may be employed for all the purposes 
for which myrrh is taken internally. 

UNICORN. 

{Helonias Dioicia.) 

This plant, the root of whicli possesses tonic properties, is 
found plentifully in most of the middle, and in several of the 
western states. It has received a variety of names; Blazing 
Star, Devils Bit, and Blazing Star Wort. The root is in ge- 
neral about an inch and a quarter in length, from a quarter to 
three-eigths of an inch in diameter, and its lower extremity ter- 
minating abruptly, as though it had been broken off. " The root 
leaves continue green all winter, and spread upon the ground in 
the form of a star. They are four or five inches long, narrow 
at the base, and terminated by a somewhat tapering point. The 
stem of the male plant is a foot or more in height, and termi- 
nates in a long, drooping, and very graceful spike of flowers, 
W'hich are of a dirty wliite colour. They remain in bloom from 
June to July. The stem of the female plant is erect, much 
taller than the otiier, and is furnished with flowers of a larger 
size. — Mattsoii^s J. V, Fradice. 

The autlior above quoted observes: *^The aletris farinosa, or 
^tar grassj which has also received the name of imicorni is often 
mistaken for this plant. It is similar in growth and appearance, 
but may be identified by its sharply pointed leaves, and brittle, 
scaly looking root. It possesses tonic properties, but it is also 
narcotic and purgative, which renders its use objectionable and 
sometimes hazardous." This plant, the aletris farinosa, has 
been introduced into Dr. Mersey's work on Midwifery, and 
also Dr. Jolin Thomson's Materia Medica as the true ** unicorn 
root" used by Thomsonians. 

The root of the helonias dioicia^ though spoken of by some in 
terms of the highest praise as a remedy, particularly adapted to 
complaints peculiar to females, yet it is very doubtful wether it 
])ossesses any specific properties apart from those of a general 
tonic. 



BITTER ALMONDS, PEACH-MEATS, AND CHERRY 
STONE MEATS. 

All these articles contain valuable tonic properties. The 
essential oil obtained from bitter almonds and peach meats by 
distillation, and supposed to contain prussic acid, docs not exist 



47^2 



MATEHIA MEDICA, 



in the almond in its natural state, but is the result of chemical 
action, which takes place dui-ing the process of distillation. 

Dr. S. Thomson has of late years in preparing No. 6, employ- 
ed liquor, in which pounded cherry stones have been kept for 
some time, which he calls ** cherry spirif This is an improve- 
ment on the old method. 

SPICE BITTERS. 

The spice bitters are variously compounded by different indi- 
viduals. Sometimes 1 have met with spice bitters that were ac- 
tively cathartic, and on other occasions containing so much of 
cloves and cinnamon as to prove decidedly binding to the 
bowels. 

The following is a good formula: take of black and white 
aspen poplar bark, finely powdered, each three pounds, of gin- 
ger two pounds, golden seal two pounds, cinnamon one pound, 
cloves one pound, prickly ash bark half a pound, cayenne half a 
pound, and eight or nine pounds of white sugar. These are all 
to be finely pulverized, thoroughly mixed together, and then run 
through a sieve. 

Next to composition and No. 6, the spice bitters are more em- 
ployed than any medicine or compound in the Thomsonian ma- 
teria medica. The usual dose is a teaspoonful prepared in de- 
coction with boiling water, or the powder may be taken with 
a small portion of luke-warm or cold water. The spice bit- 
ters prepared according to the above formula, afford a mild sti- 
mulant and tonic, which may be used with great benefit in many 
cases, and with safety under all circumstances. As a tonic in 
intermitting and remitting fever, and in cases of extreme de- 
bility and obstinate dyspepsia, the spice bitters are not to be re- 
lied upon, stronger tonics will here be demanded. 

LADIES' SPICE BITTERS. 



Adding finely powdered myrrh and unicorn root to the com- 
mon spice bitters in equal quantity with the cloves, constitutes 
what Lire termed Ladies' Spice Bitters or Woman's Friend. 

This preparation is well adapted to cases of general debility 
and especially in complaints peculiar to females. 

To make Conserve of Hollyhock. — Take of poplar bark, bay- 
berry, golden seal, cloves, cinnamon, and American valerian 
each an ounce, and half an ounce of cayenne, all finely pulve- 
rized, mix them well together and pass the compound through a 
sieve. Incorporate this powder and half an ounce of the oil of 
pennyroyal thoroughly with one pound of Hollyhock blossoms, 



MATERIA MEDIC A. 473 

previoiisiy pounded into a jelly, and form it into balls of the 
size of a large marble and dry thein, or [)ut it into jars to pre- 
serve it in a moist state. 

The conserve of hollyhock possesses the same properties as 
the spice bitters, but is ratiier more active both as a stimulant and 
tonic. It may be used on all occasions to promote digestion, 
to warm the stomach and bowels, and also as a preventive to dis- 
ease, it is a convenient medicine for persons while travelling. 



NERYl^'ES, 
To quiet restlessness^ calm nervous agilatwn, and promote sleep. 

AMERICAN VALERIAN. 

Several Species. — Cypripedmm Immilef pubescenSy parvijlo- 
rum, coiididiim, and spedabUe. 

Common names — Moccasin flower, Noah's ark, wild lady 
slipper, umbil and valerian. 

Each of the above named species of valerian possesses the 
same medical properties. The root is the part employed for 
medical purposes. The root of the American valerian dried 
and pulverized constitutes the powder known among Thom- 
sonians by the name of nerve powder. This powder is usually 
combined with emetics in giving a course of medicine, it 
is more particularly needed when the patient is of a nervous tem- 
perament. From lialf, toa full teaspoonful may be added to each 
dose of emetic. The powder may also be taken in hot water 
sweetened, or it may be added to any of the medicines when the 
the condition of the patient requires it. The root should be 
collected in the autumn, washed clean, carefully dried, and kept 
from tiie air. 

SCULLCAP. 

(^Scutellaria lateriflora.') 

This herb has recently been introduced into use as a nervine. 
It is found growing in meadows and along streams of water. 
There is a species of scullcap found upon upland, particularly 

5 I 



4T4 



MATERIA PEBICA, 



in stubble fields : whereas the species employed for medical pur- 
poses is found only in low and marshy land. 

I have not made sufficient trial of the scullcap to form an 
opinion as to its medicinal powers. It certainly possesses tonic 
properties, and it may be that its powers of quieting nervous 
agitation, and tranquilizing nervous excitement depends simply 
upon its tonic properties. New remedies are apt to be overrated 
when first introduced, more especially by those who claim the 
honour of introducing them. I am not one to advocate an ex- 
tension of the Thomsonian materia medica much beyond its pre- 
sent limits, still from testimony adduced in favour of the scuta- 
laria I do not doubt that its introduction into our materia medi- 
ca will be a valuable acquisition. 

The top of the plant is the part employed, which should be 
collected when the plant is in blossom, carefully dried and pre- 
served from the air. It may be taken prepared in the same man- 
ner and for the same purposes as Thomson's nerve powders. 

HOPS. 

Hop tea may be used with benefit as a means of quieting ner- 
vous agitation and promoting sleep. Hops are most employed 
in protracted fever and delirium tremens (craziness from drink). 

The yellow powder which may very readily be obtained from 
hops by rubbing and sifting them contain the active principle 
of hops. This powder (called lupulin) by being rubbed up 
in a warm morter will form a paste which may be made into 
pills, and taken for the purposes above mentioned. 



I have now made mention of the important articles contained 
in the Thomsonian practice, and I believe sufficient for the suc- 
cessful treatment of every form and variety of disease which 
the human constitution is liable to, that curable by the agency 
of medicine. All disease should be treated upon general princi- 
ples, the great object always to be kept in view is to assist nature. 
The general indications for the cure of disease are — 1st. To 
strengthen and sustain vital action by the employment of puro 
stimulants and the vapour bath. Sndly. To evacuate the sto- 
mach by emetics, and the bowels by injections. Srdly. To cleanse 
the mucous membrane of the stomach and bowels of morbid se- 
cretions or canker, by the use of astringents and detergents. 
And 4thly. to restore digestion by the use of tonics. 

As a general stimulant there can be no belter article employed 
than capsicum, It may be used in all cases and under all eir- 



MATERIA MEDICA. A:T 5 

cumstances, and of itself is sufficient for the cure of almost every 
form of disease of a mild cliaractcr. This together with the 
remaining articles mentioned under the head of stimulants arc 
amply sutficient to accomplish all the purposes for which stimu- 
lants are employed. 

As an emetic the lobelia injlata is superior to any other article 
that can he employed ; and prepared and administered as direc- 
ted in this work, no substitute can be used that wull answer as 
well. Besides its emetic powers, lobelia furnishes the surest 
and most effectual means that can he employed for relaxing the 
system, removing obstructions, restoring the secretions, lessen- 
ing violent excitement of the arterial system, and of maintain- 
ing an equilibrium of nervous power, and without the least de- 
gree of danger to be apprehended from its use. 

To cleanse the mucous membrane of the stomach and bowels^ 
of thickened tenacious secretions or ^^ canker^' we have bay- 
berry and sumac ; and when these are collected in the proper 
season and carefully prepared they will be sufficient for all the 
general purposes for which this class of medicines are pre- 
scribed. 

To strengthen Digestion — After the secretions are restored 
and the stomach cleansed of foul secretions, we are supplied 
with a variety of articles from the vegetable kingdom contain- 
ing the bitter principle. 

In the different classes of articles above mentioned, we have 
medicines wiiich besides fulfiling the general indication above 
mentioned, also supply the purposes of diaphoretics, cxpecto- 
rants, nervines, emmenagogues, anthelmentics, and antispasmo- 
dics. Thus the composition powder while it acts as a gentle 
stimulant, promotes perspiration and expectoration ; and if taken 
in substance operates as a detergent — scouring the mucous mem- 
brane of the stomach and bowels of canker. The composition 
powder also possesses slightly tonic properties ; and is good for 
worm complaints, and strengthens the nerves. 

A vast majority of the obstructions and ailments which occur 
in the human system, depend originallyjupon diminished power in 
the stomach — digestion is impaired, the secretions become thick- 
ened and coat the mucous membrane of the stomach, the power 
of generating heat and nervous influence is enfeebled; and w-hat- 
ever part of the system is weakest, that will be the part in which 
obstructions will be most liable to occur. The first and most 
important object, therefore, in tlie treatment of disease is to rec- 
tify the disordered condition of the stomach, and then particular 
expectorants, diuretics, &c. may be employed with advantage. 
Thus in dropsy, for instance, the functions of the skin and kid- 
neys are deranged or in a great degree suspended, in consequence 



476 MATERIA MEDICA. 

of loss of power In the stomach : and in the great majority of in- 
stances, particular diuretics as they are termed, will prove of 
little or no benefit until the condition of the stomach is improved. 
Acid in the stomach may be neutralized by taking an alkali, but 
the alkali does not remove the cause of the superabudance of 
acid. Costiveness may be removed for a time by t!ie use of a ca- 
thartic but it will not restore the natural function of the bowels, 
but on the other hand the cause of the difficulty will be increased 
thereby. Torpor of t\\Q liver is in most instances a consequence 
of derangement in the stomach, and to restore the natural action 
of the liver requires the use of means which will cleanse the 
mucous membrane of the stomach, restore its secretions and invi- 
gorate its actions, by which the liver will be furnished with the 
supply of nervous energy necessary to the performance of its 
healthy functions. 

A Thomsonian course of medicine exerts a beneficial infliN 
ence upon every important vital function, and will prove the most 
effectual means of removing obstructions in any part of the sys- 
tem. 

An acute disease (altended by fever) that cannot be cured by 
the aid of Thomsonian courses of medicine, judiciously adminis- 
tered, is not curable hy any other treatment. At least this is 
true as a general rule. I^ot that regular courses of medicine 
are necessary in all cases, nor ^ven in the majority of cases of 
ordinary attacks of disease. To keep the patient warm, and re- 
store the natural action of tlie stomach, and to cleanse it of canker 
by the use of composition, or cayenne and bayberry, is all that 
is absolutely required in ordinary attacks of disease. 

The introduction of deleterious or inefficient articles and com- 
pounds into use by professed Thomsonian or Botanic practi- 
tioners has materially retarded the progress of Thomsonism. A 
man becomes well convinced of the efficacy of Thomsonian re- 
medies, and perceiving that it is a sim.ple and plain practice, 
engages in it. At first he uses no remedies but the general 
Thomsonian medicines; but not fully comprehending the prin- 
ciples of the system, he after awhile begins to tamper with cath- 
artics and other worse than useless articles, not because he did 
not find Thomson's remedies successful, but more from a wrong 
conception of tlic ti'ue pi'inciple of treating disease. He hears 
of a certain article that is said to act spccilically upon tlie liver; 
another that is a specific for dropsy: ]»c is told of a certain cath- 
artic that ]>urgcs without causing debility, and that it may housed 
on all occasions with safety being entirely vegetable: until final- 
ly he strays entirely from Thomsonism m\\y a complete empy- 
rical practice, employing renjedics that are liable to do serious 
mischief. 



MATERIA MEDICA. 477 

The articles and compounds hereafter mentioned are to be 
employed rather as auxiliary remedies in the treatment of dis- 
ease in general, except in slight derangement of the system, 
where these weaker and less efficient remedies alone may prove 
sufficient. 



CARBONATE OF AMMONIA. 

^* Carbonate of Ammonia recently prepared is in wliite, mo- 
derately hard, translucent masses, of a striated and crystalline 
appearance, of a pungent smell, and a sharp penetrating taste." 
Z7. S, Bysp, 

Exposed to the air carbonate of ammonia soon becomes changed 
to a white appearance, and in its texture resembles chalk: when 
it is no longer of benefit as medicine. Carbonate of ammonia 
should be preserved from the air by being kept in a glass jar 
entirely air tight; cut into pieces and put in a vial, or it may be 
dipped in melted bees-wax, and as it is wanted for use, cut off 
as much as is needed, and apply a piece of wax to cover the part 
exposed. 

Medical Properties and Uses. — Carbonate of ammonia is a dif- 
fusive stimulant, and powerfully anti-acid. Its use is adapted 
to exhausted states of the system, as in congestive and typhus 
fever, and wherever extreme debility prevails. 

Tlje dose is from five to ten grains, or about as much of the 
powdered ammonia as will lay on a five cent piece. It may be 
taken dissolved in wine-whey, pepper or Virginia snake I'oot 
tea; or it may be taken in the form of pills. The dose to be re- 
peated every hour or two, as the circumstance of the case de- 
marid. 

Carbonate of ammonia though much inferior to the third pre- 
paration of lobelia in point of medicinal powers, may still be 
employed with benefit in combination w ith the third preparation, 
or with other stimulants, in cases of extreme prostration. 

The unpleasant taste of the ammonia may be disguised by dis- 
solving it in gum arable water sweetened with loaf sugar, and to 
each dose add a drop of the oil of cinnamon. 

CAMPHOR. 

Camphor is obtained chiefly from Japan, where it is found in 
distinct grains interspersed throughout the roots and wood of 
the Laurels camphora, a forest tree of that country. Camphor 
exists in small quantities in some native trees and plants of this 



478 matehia mebica. 

country — the common sassafras, and in rosemary, sage, pep- 
permint, thyme, starwort and lavender. 

Camphor is seldom employed internally except in case of colic. 
It may be taken in the form of spirits of camphor, or take a piece 
of camphor about the size of an ordinary grain of corn, rub it 
up with a portifui of gum arabic, myrrh, and loaf sugar, then 
add a wineglassful of water, stir it well and take at once. 

Camphor dissolved in Tliomson's No. 6, forms a useful ap- 
plication in cases of sprains and bruises. 

OIL OF TURPENTINE. 

The oil of turpentine is obtained from common turpen- 
tine by the process of distillation. Internally it may some- 
times be used with benefit in chihiren affected with worms; and 
also as an adjuvant remedy in low forms of fever. ** There is a 
particular state of fever usually attended with much danger, in 
which we have found this remedy uniformly successful. The 
condition of things alluded to, is one which occurs in the latter 
stages of typhoid fever or lingering remittents, in which the 
tongue having begun to throw off its load of fur in patches, has 
suddenly ceased to clean itself, and becoming dry and brownish: 
the skin is at the same time dry, the bowels torpid and distend- 
ed with flatus, and the patient sometimes affected with slight de- 
lirium. Under the use of small doses of the oil of turpentine, 
frequently repeated, the tongue becomes moist and again coated, 
the tympanitic state of the bowels disappears, and the patient 
goes on to recover as in a favourable case of fever. We are dis- 
posed to ascribe the effect, to a healthy change produced by the 
oil in the ulcerated surface of the intestines."— i7. ^S^. I)ysp, 

The oil of turpentine given internally has been found useful in 
cases of lumbago and sciatica. It has also been employed in 
severe cases of bilious colic. A tablespoonful of the oil of tur- 
pentine beat up with the yolk of an eg^, and half a pint of 
warm water added, may be employed with benefit as an injec* 
tion in severe cases of bilious colic. 

Next to the third preparation of lobelia the oil of turpentine 
is probably the best remedy, used by injection, in cases of tympa- 
nites — a swollen condition of the abdomen — which often occurs 
in malignant forms of disease and in peritoneal inflammation. 

A teaspoonful of oil of turpentine beat up with the yolk of an 
egg, and a teaspoonful of tlie mixture taken at a time, and occa- 
sionally repeated is said to be one of the surest of means of check- 
ing bleeding from the nose in typhoid fever. 

Oil of turpentine has been much extolled as a remedy for tape 
worm. It has also been found useful in neuralgia, locked jaw, 
dysentery, and in long standing weakness of the urinary organs. 



MATERIA MEBICA. 4T9 

It is not, however, to be considered a specific for any disease; 
but in certain conditions of the system, it may be employed with 
benefit. 

The dose is from five to thirty drops. It may be taken drop- 
ped on sugar, or combined with mucillage of elm or gum arabic 
and sugar. 

As an external application it may be usefully em])loyed in 
combination with Thomson's No. 6, in low forms of fevei's, when 
the skin is colder than natural. This compound also forms a 
useful application in case of rheumatism and palsy. It is a good 
application in chilblains, and also in the cure of various species 
of eruptions. 

OIL OF AMBER. 

** Amber is a kind of fossil resin of vegetable origin, occur- 
ring generally in small detached masses, in alluvial deposites, 
in different parts of the world. It is found chiefly in Prussia, 
either on the sea shore where it is thrown up by the Baltic, or un- 
derneatli the surface, in the alluvial formations along the coast." 
U, 8. Bysp. 

Amber has also been fonnd in Maryland and New Jersey. 

Oil of amber is obtained by putting a quantity of powdered 
amber and an equal weight of sand, into a glass retort and a 
gradual heat applied by means of a sand bath; an oil exudes, 
which is separated from the other matters, which should be kept 
in tightly corked bottles. The oil of amber thus obtained is sub- 
jected to a process of distillation with water, when it is ready for 
medical purposesc 

Medical Pr&perties and Uses, — Rectified oil of amber is an an- 
tispasmodic and stimulant, useful in hysteria, violent colic, hic- 
cough, and in water brash attended with cramps or spasms. 

A dose of the Oil of Amher is from five to fifteen drops, rubbed 
up with a portion of gum arabic or slippery elm and sugar, and 
then add a portion of water. 

As an external application it is useful in palsy and chronic 
rheumatism. 

OIL OF HORSEMINT. 

Oil of horsemint may be used internally in cases of colic, 
heart-burn, water brash, and in gout or spasms in the stomach. 
The dose is from two to five drops mixed with sugar and water. 
The oil of horsemint applied to the skin produces a very sudden 
rubefacient effect, causing redness of the skin and even blistering. 



480 



MATERIA MEDICA. 



OIL OF PEPPERMINT. 

The oil of peppermint is used to relieve colic, overcome nau- 
sea, and check vomiting. The dose of the oil is from one to 
three drops, first rubhed up with sugar and then water added. 

The Essence of Peppermint is made by combining two ounces 
of the oil with a pint of alcohol. The dose of the essence is from 
ten to twenty drops. 

OIL OF ANISE SEED. 

The oil obtained from anise seed is well adapted to colic pains 
in infants, on account of its mildness. The dose is from three 
to fifteen drops, rubbed with a small quantity of loaf sugar and 
then add a teaspoonful or tablespoonful of hot water. 

OIL OF CARAWAY. 

Oiii of caraway is chiefly employed to disguise the taste of me- 
dicine, and is much employed by nostrum venders to give an 
agreeable flavour to syrups and pills. 



VEGETABLE BALSAMS, 



BALSAM COPAIVA. 



B AXSAM copaiva is obtained from the copaifera officinalis. This 
tree is a ** native of Venezula, and grows in the province of 
Carthagena, mingled with the trees which afford the balsam tolu. 
It grows also in the West India islands particularly Trinidad 
and Martinique, where it is said to be naturalised. The juice 
is obtained by wounding the tree ; and the operation is said to 
be performed several times in the same season. As it flows from 
the wound, it is clear, colourless, and runs thin, but soon ac- 
quires a thicker consistence and a yellowish tinge." 

Balsam copaiva has long been employed as a remedy in go- 
norrhoea and fluor albus. In a favourable condition of the sto- 
mach the use of balsam copaiva is particularly beneficial in the 
above named complaints. It may also be employed with advan- 
tage in chronic bronchitis attended with a copious expectoration 
of thick yellowish secretion. It has also been found serviceable 
in cases of chronic diarrhcEa. 



MATERIA MEDICA. 481 

The dose of copaiva is from fifteen to thirty drops, repeated 
three or four times a day. It is usually taken rubbed up with 
powdered gum Arabic or powdered elm and sugar, adding a 
drop or two of the oil of pepperment or cinnamon, to which add 
asutficient quantity of water to form it into a consistency con- 
venient to be taken. Another method recommended for taking 
this medicine is, to drop the copaiva in a wineglass half full of 
water, and immediately drop on it a few drops of a bitter tinc- 
ture ; the copaiva is collected in a globule and may be swallow- 
ed without imparting its peculiar taste to the mouth. Recently, 
liowever, the balsam copaiva is taken enclosed in capsules, by 
which both the taste and odour of the article are completely dis- 
guised. 

BALSAM TOLU. 

Balsam tolu is obtained from a tree growing near Carthagena. 
It is obtained by making incisions into the trunk of the tree 
from which a juice exudes which is allowed to concrete. On 
keeping, the balsam becomes hard and brittle like resin. 

The dose is from half to an even teaspoonfulof the powdered 
balsam. *^ The best form of administration is that of emulsion 
made by triturating the balsam with mucillage of gum Arabic 
and loaf sugar, and afterwards with water. 

Balsam tolu is found beneficial as a remedy in long standing 
cough, chronic catarrh and bronchitis. 

FIR BALSAM. 

Canada Balsam, 

The tree wliich furnishes this balsam grows in Maine and Ca- 
nada. The balsam collects in blisters on the body of the tree, 
which are pierced and the liquid received into vessels. 

r/ses.— Balsam of fir is employed for the same purposes for which 
balsam copaiva is used. The fir balsam is inferior to the balsam 
copaiva in point of medicinal powers. The usual dose is about 
twenty drops. It may be taken rubbed up with a portion of su- 
gar or gum Arabic. 



The following named herbs may be usefully employed as 
mild stimlants and to promote perspiration, to wit: pennyroyal, 
ditany or horsemint, cartnip, thyme, spearmint, sweet-marjo- 
ram, and summer-savorv. 

5 K 



482 MATERIA MEDICA. 

SCABIOUS. 

Errigeron PhiladelpMcum and Errigeron Canadense, 

Each of the above species of the errigeron, grow plentifully 
in the fields in the vicinity of Philadelphia. By some the erri- 
geron is called Jleabane. 

A tea of the scabious is an important remedy in cases of gra- 
vel, and inflammation of the neck of the bladder ; and may be 
used freely in complaints of the kidneys and bladder. A de- 
coction of this herb may be usefully employed as a common 
drink in a variety of disorders, such as gout, dropsy, and dy- 
sentery. 

PIPSISSEWA. 

(Pyrola Umbellata,) 

This evergreen of which the tops and roots are both used, 
possesses some valuable medical properties. A decoction of tiiis 
plant may be used with benefit as a common drink in scrofulous 
eruptions, rheumatism, dropsy, and in complaints of the urinary 
organs in general. Sweetened with honey and drank freely it 
will in general promote the discharge of urine, relieve strangu- 
ary, and assist expectoration. 

In order to obtain the full strength of the pipsissewa in de- 
coction, it should be boiled half an hour in an earthen vessel. 

CLEAVERS. 



There are several species of the cleavers all of which possess 
similar properties. A strong decoction is said to be useful in 
urinary obstructions, and in inflammation of the urethra or 
neck of the bladder. 

BURDOCK. 



The root of Burdock cut into thin slices and put into sound 
cider, adding a small portion of horseradish and mustard seed, 
furnishes a wholesome drink ; and in certain conditions of the 
stomach — where the patient has a desire for cider, as is often 
the case after fevers, this preparation may be found not only 
grateful but it will also strengthen the digestive functions. In 
dropsy, after the stomach has been cleansed, and the patient 
has passed through a course of general constitutional treatment^ 



MATERIA MEDICA. 483 

this cider preparation will generally prove beneficial, giving tone 
to the stomach and promoting the secretion of urine. 

PRICKLY ASH. 

(^ZantJioxylum Framneiim.) 

The prickly ash is a bush growing in wet and shady places, 
and seldom exceeds in height ten feet. ^^The leaves are alter- 
nate and pinnate, consisting of four or five pairs of leaflets, and 
an odd terminal one, with a common footstalk which is some= 
times prickly on the back, sometimes unarmed. The leaflets are 
nearly sessile, ovate, acute, slightly serrate, and somewhat 
downy on their under surface." *' The flowers are small and 
of a yellow colour, growing in little clusters close to the branches. 
They appear in May, in advance of the leaves. The seed ves- 
sels have the appearance of berries; and during the summer 
change from a green to a red ; in tlie autumn they assume a 
brownish colour,, and open by three valves: exhibiting a black 
polished seed in the centre." — Mattson, 

^' Dr. Bigelow informs us that the Jlralia spinosa^ or angelica 
tree, which grows in the southern states, is occasionally con- 
founded with the Tjantlioxylum fraxantnmj m consequence partly 
of being sometimes called like the latter pnc/t% aslu Its bark, 
however in appearance and flavour is entirely different from the 
zanthoxylum. — Wood and Bache. 

The bark and leaves of prickly ash are extremely pungent 
when chewed. The pulverised bark seed and capsules, added 
to other tonics constitutes a good medicine in cases of rheuma- 
tism where a tonic is wanting. A decoction of these articles 
alone or combined with cayenne or composition may be used in 
any stage of rheumatism. It is stated that a decoction of the 
prickly ash bark is a useful remedy in venereal complaints, fluor 
albus, and in general weakness of the urinary organs. The 
berries may be used to impart an agreable flavour to wine 
bitters. 

SARSAPARILLA. 

There are various species of sarsaparilla, only a few of which 
according to the observation of some travellers possess any val- 
uable medical properties. The American sarsaparill a appears 
to be entirely inert. Indeed the majority of that which is im- 
ported is of little value, from which circumstance no doubt it has 
lost its reputation with many as a medicine. ** The only crite- 
rion of good sarsaparilla which can be relied upon is its taste. 
If it have a decidedly acrid impression in the mouth after hav- 



484 



MATERIA MEDIC A* 



ing been chewed for a short time, it may he considered efficient; 
if otherwise, it is probably inert." 

To pre'pare a simple decoction of Sarsaparilla. — Bruise tho- 
roughly the roots of good sarsaparilla, sift out the dirt, pour 
on boiling water, and let it steep two or three hours by a fire in 
a covered vessel: strain and sweeten with sugar or honey. 

To make Sarsaparilla Beer* — Take of sarsaparilla root bruised 
one pound; guiac shavings, anise seed and liquorice root each 
two ounces; good molasses one pound; and half a dozen bruised 
cloves; pour upon these two gallons of boiling water, and shake 
the vessel several times a day. After fermentation takes place 
it is fit for use. 

Compound Decoction of Sarsaparilla. — Take half a pound of 
bruised sarsaparilla bark of the root of sassafras sliced, guia- 
cum wood, rasped, liquorice root bruised, each an ounce; pour 
on these irsgredients half a gallon of boiling water and let it boil 
a quarter of an hour and strain. 

Excepting the omission of one article, this decoction is an im- 
itation of the celebrated Lisbon diet drink. 

The decoction may be sweetened with rock candy, sugar or 
honey. 

Syrup of sarsaparilla may be made in the following manner. 
Take of good sarsaparilla bruised two pounds; guiac shavings 
three ounces; red i-ose leaves, and liquorice root bruised, each 
two ounces; add to these ingredients five quarts of diluted alco- 
hol, and let it macerate fourteen days, then strain through thick 
muslin. Evaporate the tincture by means of a water bath, to 
four pints and a half; then add eight pounds of refined sugar, 
and simmer until it forms a syrup. Then take a teacup half 
full of the syrup and add to it a teaspoonful of the oil of winter 
green, mix them thoroughly and stir it into the whole of the 
syrup. 

Uses, — Sarsaparilla either in decoction or syrup, is often 
found beneficial in scrofula where the patient is in an emaciated 
and feeble condition; in mercurial disease; secondary syphilis; 
various eruptive diseases; and in a great variety of complaints 
of long standing attended with emaciation and debility. 

GUIACUM WOOD. 



Guiacum wood is imported to the United States from the West 
Indies, in the form of logs or billets. It is commonly called 
lignum vitse. It is j)ossessed of some medicinal properties, and 
is employed in cases of chronic rheumatism, cutaneous erup- 



MATERIA MEDIC A. 485 

tions and scrofula. The wood is kept by apothecaries in the 
form of raspings or shavings. The wood yields the greater 
part of its properties to boiling water. It is seldom, however, 
administered alone, being mostly combined with other articles, 
particularly sarsaparilla. The concrete juice of the guiacum 
tree, commonly called gum guaiac, is employed for the same 
purposes for which the decoction of the wood is given. It may 
be taken either finely powdered and mixed with molasses or sy- 
rup, or in the shape of emulsion wdth powdered slippery elm, 
sugar and water, or in tincture. The dose of the powder is 
from half to a teaspoon even full. Guaiac is sometimes added 
to Thomson's No. 6, and administered internally in cases of 
rheumatism, gout, female weakness, mercurial disease and sy- 
philitic taint of the system. 

WORM WOOD. 

This garden shrub possesses the bitter principle in a high de° 
gree, and may be employed as a bitter tonic. 

TANSY. 

Tansy is used both as a tonic and vermifuge. For children 
supposed to be affected with worms, the leaves either in the green 
or dried state, are boiled in milk, and a wineglassful given three 
or four times a day. It is particularly adapted to a feeble and 
relaxed state of the system where the use of tonics are indi- 
cated. 

SLIPPERY ELM BARK. 

{Ulmus Fiilva.) 

SiiiPPERY ELM BARK is employed as a demulcent, by stirring 
the finely ground bark into hot water, or by pouring hot water 
upon the bark unground, and allowing it to steep. The mucil- 
lage of slippery elm bark is very nutritious, and it may be em- 
ployed as an article of diet in fever, pleurisy, inflammation of 
the lungs, scarlet fever, diarrhoea, dysentery, and in any other 
form or variety of disease, especially when accompanied 
with fever, for the stomach is very rarely in a condition to di- 
gest food when it is so much disordered as to occasion fever, ex- 
cept the food be of the lightest kind, such as elm gruel, barley 
water and gum arable water. A mucillage of slippery elm 
sweetened with loaf sugar or rock candy, adding a portion of 
lemon juice, is a good remedy for cough that is attended by 
fever and a dryness of the tongue. 



486 



MATERIA MEDICA. 



To form an emollient poultice there is no article superior to 
finely powdered slippery elm bark. 



£CID8. 



VINEGAR 






The use of vinegar on food promotes digestion in particular 
conditions of the stomach. With the addition of salt and cay- 
enne pepper, it constitutes pepper sauce. This preparation is 
useful as an internal remedy in many cases of disease, and par- 
ticularly so in some cases of fever, where the patient desires or 
craves acids. I know families who depend almost exclusively 
upon the internal use of a mixture of salt and vinegar in all 
cases of dysentery and bowel complaints. Although this is un- 
doubtedly a valuable remedy, yet certainly not one to be relied 
upon exclusively, in diarrhoea or dysentery. Pepper sauce 
forms one of the best applications for tlie cure of ulcerated sore 
throat wliich so often attends scarlet fever. The throat must 
be swabbed with the mixture and a dose occasionally adminis- 
tered. On many occasions when patients have expressed a de- 
sire for acid, I have directed them to take stale wheat bread 
dipped in vinegar, and it has agreed well with the stomach in 
every case where I have recommended it. Within the past 
month a patient of mine eat freely of bread soaked in vinegar 
and continued to take it three or four days, not only without 
receiving any injury from it, but on the contrary it was evi- 
dently of especial benefit as a medicine. This patient was af- 
fected with a form of disease which would have been termed 
congestive fever by medical men in general. 

Some dyspeptics find nothing to set so well on the stomach as 
bread and butter dipped in vinegar. Even in cases of sour sto- 
mach, vinegar or lemon juice has been found in some instances 
to suit the stomach better than alkalies. 



Lemon juice may be used for the same purposes as vinegar in 
cases of sickness. Yery often we find that a mixture of lemon 
juice and sugar, in the form of syrup, to suit the stomach re~ 
markably well in cases of disease, particularly in fever. 

Pepper sauce is useful as an external application in case of 
sprains, bruises, rheumatism, &c. 



MATERIA MEDIC A. 487 

ELIXIR OF VITRIOL. 

This preparation consists of sulphuric acid, alcohol, and the 
essential oil of ginger and cinnamon. 

I have employed elixir of vitriol with especial benefit in some 
cases of disease, and though seldom employed in the Thomsonian 
practice, still I do not perceive any objection to its use as a me- 
dicine in the diluted state in which it is administered. It may be 
employed to moderate night sweats, and as a tonic in intermit- 
ting fever or ague, particularly when the system is brought into 
a condition to admit of their use. In hectic fever and in con- 
sumption attended with urgent thirst, a few drops of the elixir 
of vitriol, added to a glass of water, will prove grateful to the 
taste, and tends to check thirst. 

The dose of elixir of vitrol is from ten to thirty drops taken 
in a wineglassful of water, or in ginger or bitter tea. It is of- 
ten given combined with a decoction of Peruvian bark, in cases 
of remitting fever. 

ALKALIES— ANTI-ACIDS. 

Super Carbonate of Soda — Bi-carbonate of Soda. 

Soda is obtained from the ashes of sea w^eeds. It is suj)jected 
to certain processes by which it becomes purified and well adapt- 
ed to general use as an anti-acid, in the form of the sup. carbo- 
nate, or bi-carbonate of soda. 

It is a stronger anti-acid than pearl ash, and is preferable to 
the latter on account of not being as liable to impurities as pearl 
ash is on exposure to the air or from long keeping. 

Soda is preferable to saleeratus for neutralizing acid, and in 
assisting the operation of emetics. 

Sup. carbonate of soda will generally overcome heartburn, 
and affords great relief in case of acidity and distress at the sto- 
mach after eating. It is a favourite medicine with epicures. 

SAL^RATUS. 

Sal^ratus as it is commonly called is the bi-carbonate of pot- 
assa. It is employed in the place of pearl ash, being less liable 
to impurities than the latter. It is used for the same medical pur- 
poses as the sup. carbonate of soda. It is more used by Thomso- 
nians than the sup. carb. soda, but it is not so strong an alkali 
as soda and it is more unpleasant to take. 



488 



MATERIA MEDIC A. 



HICKORY ASHES. 

A TEA made by pouring boiling water on bickory asbes, may 
be employed as an anti-acid wben bi-carbonate of soda or salsera- 
tus cannot be obtained. A tea of bickory ashes bas been used 
with much benefit in some cases of dyspepsia attended with a 
superabundance of acid in the stomach. 

The following was a favourite remedy for dyspepsia with the 
late Dr. Pjiysic : 

<^A quart of bickory asbes, a teacupful of soot, and a 
gallon of boiling water." 

Dose.— A wineglassful of the tea immediately after meals. 
CHARCOAL. 

The cliarcoal employed for medical purposes is generally ob- 
tained from those who manufacture gunpowder. In their esta- 
blishments the charcoal is burned in iron cylinders by which it 
is freed from all impurities ; then being finely pulverized for 
the purpose of powder making, it is well adapted also for medi- 
cal purposes, Common charcoal is rarely entirely clear of im- 
purities, and consequently it is not so well adapted to medical 
purposes as that prepared by the powder makers. There are 
processes however for purifying the common charcoal and fitting 
it for ftiedical purposes, as follows :— Fill a crucible with ordi- 
nary charcoal reduced to fine powder, and lute on a perforated 
cover. Then expose the whole to a sti'ong red beat, and con- 
tinue the ignition as long as a blue flame issues from the aper- 
ture in the cover ; \vhen this ceases, allow the charcoal to cool 
and transfer it immediately to bottles which must be kept well 
stopped.'' — U. S. Bijsp, 

Another method. — ^^Take any quantity of thoroughly burnt 
cliarcoal, very light, sonorous and pure, made from the wood 
of the linden tree, willow, poplar, or some other of the lighter 
woods and moisten it with water. Reduce it to powder in an iron 
mortar, or by means of a mill ; and iiaving mixed it with water 
to form a thin fluid mass, let it stand for a few days ; after which 
place it in linen cloths, to drain. Makeup the paste into round 
cakes, and expose them to the rays of the sun until they are 
thoroughly dried. By this process of insulation, the charcoal, 
it is stated in the codex is deprived of all adventitious colour and 
smell, and is singularly improved in efficiency." — l^id. 

Chemical properties and wses.— Charcoal is absorbent and 



MATERIA. MEDICA. 48^ 

fjowerfull J antiseptic. Fresh meat may be preserved for months 
by being enclosed in a box of charcoal. Tainted meat may be 
sweetened by placing it in powdered charcoal. 

Charcoal may be used with especial benefit in many cases of 
dyspepsia attended with putrid or sour eructations. It also 
proves a mechanical stimulant to the bowels and may be employ- 
ed to overcome costiveness. In fevers when there is a sour taste 
in the mouth, charcoal mixed in pepper tea and given freely is 
attended with good results. I have made considerable use of 
charcoal combined with other medicine in obstinate costiveness, 
and have invariably found it useful. It is a good remedy for 
constipation and heartburn, which so often attend the latter* 
stages of pregnancy. 

The dose of charcoal is from a teaspoonful to a tablespoonful, 
to be repeated three or four times a day. To prepare the pow- 
der for taking, it should first be formaed into the form of a pasta 
with a little sugar and water, and then it will combine readily 
with liquids. By preparing it in spice bitters, composition, or 
pepper tea, the patient will obtain the benefit of both medicines 
in one dose. For children it may be mixed with boiled milk. 
It is stated by some persons who have travelled through the sickly 
districts of the western and southern states, that by using char- 
coal freely, even strangers unaccustomed to the climate may 
reside in those districts without being attacked with disease* 

LIMEWATER. 

To prepare LimetOater. — Take of fresh burnt lime two ouncesj, 
put it in an earthen vessel and pour on half a gallon of cold 
water ; stir it occasionally with a piece of wood, and in the 
course of three hours put it into glass vessels and keep them 
corked. Pour off the clear part only for use. 

Limewater is good to neutralize acidity in the stomach, to 
correct offensive breath, and overcome putrid eructations. A la- 
dy of tliis city informs me that for several years her diet consist- 
ed of boiled milk with the addition of about one fourth its quan- 
tity of limewater; almost every other kind of food soured in 
the stomach causing distress and vomiting. Persons subject to 
offensive eructations, which they say taste like rotten eggs will 
find especial benefit from the use of limewater. Chronic erup- 
tions in children are generally attended with acidity of the sto- 
mach, which may be relieved by the use of limewater. It may 
be employed with benefit in children who have worms, having 
the effect as it is asserted to dissolve the tenacious mucous in the 
stomach and bowels which supports worms. It is also useful in 
ordinary bowel complaints of children. 

3 L 



490 



MATERIA MEDICA. 



The dose of limewater for an adult, is from two to four ounces. 
It should be combined with about an equal portion of milk. Th® 
dose to be repeated three or four times a day. 

PREPARED CHALK. 

Prepared chalk is obtained by rubbing a portion of common 
chalk in an iron or earthen mortar, with a small portion of wa- 
ter ; and when rubbed very fine it is put into a larger vessel, 
and a considerable quantity of water added ; then it is to be 
thoroughly stirred so that the fine particles of chalk will be sus- 
pended in thew^aterand the impurities, sand, &c. will remain 
in tlie bottom of the vessel or soon settle. This water containing 
the fine chalk is to be poured into another vessel, and when the 
ehalk settles, the clear water is to be poured off, and the chalk 
dried. 

Medical Properties and t/ses.— Prepared chalk is anti-acid and 
absorbent, and as such it may be employed with benefit in dis- 
eases attended with a superabundance of acids in the stomach 
and bowels. A teaspoonful of prepared chalk mixed with a 
teacup half full of strong bayberry or composition tea sweeten- 
ed, forms a useful preparation in bowel complaints of children. 
In severe cases the use of the vapour bath, emetics and injection© 
must be chiefly relied upon ; prepared chalk is to be employed 
merely as an auxiliary remedy, 

STIMULATING LINIMENT. 



There are a great variety of stimulating liniments, but 
that which is frequently alluded to in the practical part of this' 
work, is prepared by my brother, A. Comfort. The basis of 
this liniment is gum elastic. It is an imitation of Col. Jewett's 
liniment, and which I know to be beneficial as an external appli» 
cation. It contains a large portion of essential oils and the li- 
quid of the 3rd preparation of lobelia. This liniment is one of 
the best external applications I have ever employed. This lini- 
ment is well adapted to neuralgia, rheumatism, and chronic erup- 
tions. I have also found it especially beneficial applied to the 
surface after a vapour bath in cases of asthma, chronic bronchi- 
tis, chronic pleurisy, night-sweats, marasmas, St. Vitus' dance, 
cholera, infantum, and dropsy ; and wiierever the skin is in a 
cold or relaxed condition. Spread upon oiled silk or soft lea-^ 
ther, it forms a useful plaster in cases of pain in the side, disease 
of the chest, swollen joints, consumption, &c. kc« 



MATERIA MEDICA. 491 

No. 3 PILLS. 

No. 3 pills are often mentioned in this work in the directions 
for the treatment of disease. They contain the medical pro- 
perties of bayberry root bark, obtained by first making a strong 
tincture of the bark, and by a slow heat the alcohol and water are 
evaporated leaving an extract in the vessel. A glass vessel must 
always be employed for obtaining the extract of bayberry or of 
any of the astringent medicines. Iron or German silver spoons 
should not be employed in preparing medicine for patients or at 
least, they should not be allowed to remain long in any astrin- 
gent tea. 

The No. 3 pills may be used in many instances as a substitute 
for bayberry tea, more especially in chronic disorders, excepting 
dropsy, as in this form of disease the compound lobelia pills will 
always be found more serviceable. 

OF COX^GH MIXTURES. 

A GREAT diversity of compounds and syrups may be employ- 
ed with benefit in cases of cough, yet none of tiiem are to be re- 
lied upon further than as a means of relief : the general Thom- 
sonian treatment constitutes the surest means of curing cough. 
A course of medicine will often relieve a cough when all other 
means have failed. 

Dr. S. Thomson in treating of cough, observes <<The gene- 
ral opinion is that cough is an enemy to liealtli, and ought to be 
treated as such ; but this I hold to be altogether an error, for 
cough is the effect and not the cause of disease. When the 
lungs are diseased there will be a collection of matter, which 
must be thrown off; and the cough is like the pump of a ship, 
which discharges the water and prevents her from sinking : so 
also the cough throws off what collects in the lungs, which if 
suffered to remain would soon putrify and cause death." 

The correct way to cure a cough is to remove the cause and 
not to deaden the sensibilities by the use of anodynes ; for though 
these may afford relief for a time, they directly tend to impair 
the functions of the stomach and bowels. There are circum- 
stances, however, under which it may be proper to administer 
anodynes; for instance in cases of deep consumption where the 
cough is so extremely liarassing as to prevent the patient from 
sleeping at night. 

Ordinary cough caused by cold may be cured by taking com- 
position or pepper tea ; whereas, in cases of seated disease of 
the lungs courses of medicine will be needed. A variety of 
cough mixtures liowever of a mild character may be employed 



4ii^ 



MATERIA MEBICA. 



with more or less benefit in cases of hard cough or difficult ex« 
pectoration. 

The most effectual cough medicine that I have employed apart 
from Thomsonian courses of medicine is lobelia given in brokeii 
doses either in the form of tincture or in powder. 

COUGH POWDER, 

Eq^uai. portions of lobelia powder, powdered liver wort, and 
jinely pulverized skunk cabbage root freshly dried, may be some- 
times used with more benefit than lobelia alone. 

In recent cough, demulcents, gum arabic, slippery elm, flax^ 
seed, and Irish moss mucillage, may be useful, more especially 
if the patient be feverish and inclined to drink, whereas in coughs 
that have been of long standing, or have become deeply seated, 
they will seldom prove of essential benefit. Mucillages may be 
rendered more agreeable to the taste, and their medicinal proper- 
ties improved by the addition of lemon juice and sweetened with 
rock candy, loaf sugar or honey. 

The following preparation is often employed as a cough me-' 
dicine. 

Take a tablespoonful of pow^dered liquorice root, add a pint 
of boiling water, then strain, and sweeten with a tablespoonful 
of honey, and add the juice of half a lemon. To a wineglassful 
of this mixture add half a teaspoonful of the tincture of lobelia. 
Repeat the dose every two or three hours, as the circumstances 
of the case may demand. 

Thomsonian pepper candy and conserve of hollyhock are much 
used for cougli, and they are generally found to answer a good 
purpose. 

Several other cough mixtures are mentioned in the treatment 
©f colds and bronchitis, which it is unnecessary to describe here=. 



VOLATILE LOTIONS AND LINIMENTS, 



Take of aqua ammonia 5 tablespoonsful, 
Spirits of rosemary 4 ditto, 
Spirits of camphor 1 ditto. 

This compound forms the celebrated GranviWs Lotion, at one 
time considered as almost a certain cure for neuralgia or tic-dou- 
loureux, and acute rheumatism. The mode of applying it is to 
wet a piece of cotton with it, and lay it on the part affected. It 



MATERIA MEDIC A. 493 

must not be rubbed or it will blister tbe part. Neuralgic pains 
have been cured in many instances by tlie application of Gran- 
vill's lotion. 

AMMONIA LINIMENT. 

Take of water of ammonia one tablespoonful, of sweet oil six 
tablespoonsful, and mix them thoroughly. 

This liniment is chiefly employed in inflammatory rheuma-^ 
tism, sprains and bruises. 

CAMPHOR LINIMENT. 

Camphor liniment is prepared by dissolving half an ounce of 
gnm camphor in four fluid ounces of sweet oil. Tliis prepara- 
tion may be used in cases of bruises, sprains, acute rheumatism, 
&c. 

SOAP LINIMENT. 

This liniment may be prepared by dissolving an ounce of 
camphor, and of oil of rosemary and oil of origanum, each a 
fluid drachm in a pint of alcohol; then add three ounces of cas-^ 
tile soap, and keep it several days in a warm place. 

The above compound forms an article extensively employed as 
as external application, under the name of opodeldoc. 

SIMPLE CERATE. 

Melt together one ounce of spermaceti and three ounces of 
wbite wax; and then add six ounces of olive oil. 

Simple cerate may be employed as a salve to protect raw^ sur- 
faces from the air. It contains no irritating properties, pro- 
vided it be made of good articles. 

BASILICON OINTMENT. 

Basilicon OINTMENT is prepared by melting together /re 
ounces of resin, eight ounces of lard, and two ounces of yellow 
bees-wax. 

This ointment is employed as a salve in cases of ulcers, burnSji 
scalds and chilblains. 

THOMSON'S SALYE. 

Take of bees-wax and fresh butter, each one pound; of tur- 
pentine one and a half pounds; and three quarters of a pound of 



494 



MATERIA MEDICA. 



balsam of fir. Simmer by the fire until all the wax is melted, and 
then strain. 

This preparation commonly called Thomson's healing salve, 
may be employed to protect injured parts from the action of the 
air, and in this way assist the healing efforts of nature. This 
and the basilicon ointment may be used for the same purpose. 

ASTRINGENT OINTMENT. 

Take a pound of sheep suet, melt it and add two ounces of 
witch hazle or sumac leaves that have been collected in the 
proper season and well dried. Simmer these half an hour or 
more, and strain whilst warm. This ointment may be used with 
benefit in cases of piles^ chafing, chopped hands, sore nipples, 
&c. 

PITCH PLASTER. 

Take of Burgundy pitch and Venice turpentine, each one 
pound, melt them together, and add an ounce of cayenne pepper, 
and when it cools, if it be found too hard, melt it over, and add 
a portion of sweet oil. 

This may be employed as a general strengthening plaster. 

THOMSON'S STRENGTHENING PLASTER. 

To make this take an equal quantity of burdock and mullen 
leaves, sufficient to fill a large kettle, fill it with water, and boil 
an hour or more; then strain and boil the liquid down to the con- 
sistency of molasses: then add one pound of resin and five ounces 
of turpentine for every quart of the extract, and after simmer- 
ing until the greater part of the water is evaporated, pour the 
compound into cold water, and work as the shoemakers do their 
wax. The addition of cayenne improves the effect of this plaster. 



MUSTARD PLASTER. 

A simple mustard plaster may be prepared by mixing ground 
mustard and warm water to form a proper consistency for a 
plaster. If it is desired to weaken the plaster, wheat or rye 
flour may be added, 

A very common form of preparing mustard plaster is to take 
equal quantities of ground mustard and wheat or rye flour, and 
moisten them with vinegar. 

Mustard plasters are often found serviceable when not left 
on so long as to occasion a blister. 



MATERIA MEDICA. 495 

CAYENNE POULTICE. 

Take equal quantities of cayenne and slippery elm powder, 
mix them with warm water to form a proper consistence for a 
poultice. 

Cayenne may be advantageously employed in cases of weak- 
ness of the spine, chronic rheumatism of joints, white swelling, 
hip disease, chronic pleurisy, painter's colic, lumbago, palsy, 
and indolent ulcers. 

EMOLLIENT AND SLIGHTLY STIMULATING 
POULTICES. 

Take of slippery elm powder two parts, w'hite pond lily root, 
pulverized, one part, pounded cracker one part; mix with warm 
water. 

This poultice may be used in all cases of biles and tumours 
attended with inflammation, and in cases of injuries when the 
flesh is lacerated. It also forms a suitable poultice for acute in- 
flammation of the eyes, and when a part is burned with a red 
hot iron or live coals, so as to sear the flesh. 

MALLOWS POULTICE. 

Take of mallows either in a green or dried state, steep them 
in milk and thicken with elm powder, ground flaxseed or fine 
Indian meal. This forms a useful poultice in the early stage of 
biles, felons, whitlows, &c. After a boile or abscess breaks, or 
is opened, a more stimulating and astringent poultice should be 
applied, such as the one first described, with the addition of a 
proper portion of ginger. 

CATNIP POULTICE. 

Catnip leaves steeped in water, and thickened with slippery- 
elm, ground flaxseed, or fine Indian meal, form a poultice that 
may be applied with especial benefit in cases of ear-ache, and in 
acute inflammation of the eyes. 

CHARCOAL POULTICE. 

Take of purified charcoal three parts, ginger one part, slip- 
pery elm two parts; mix them in warm water. 

This poultice is applicable in cases of putrid and offensive ul- 
cers, and also in gangrene. 



496 



MATERIA MEDICA. 



YEAST POULTICE. 

Take a quantity of yeast and thicken with a mixture made at 
equal portions of ginger and rye or wheat flour. Set it in a 
warm place until it begins to rise. 

The yeast poultice may be employed in all cases of gangrene^ 
mortification, &c. sloughing and offensive ulcers. 

MYRRH POULTICE. 

EquAL quantities of the dregs of No. 6 and slippery elm pow= 
der, moistened with water, may be employed with especial ad^ 
vantage in cases of indolent nlcers, carbuncle, and long stand- 
ing inflammation. This form of poultice requires to be moist^ 
ened occasionally, more particularly when it is applied to a part 
in which there is an unnatural degree of heat. 

GUM ARABIC. 

Gum ARABIC exudes spontaneously from the bark of a tree 
that grows abundantly in many parts of the continent of Africa. 
** Calculated by nature for a dry and sandy soil,'* the tree that 
furnishes this gum ''flourishes in deserts where no other trees 
will grow, and even the date tree perishes. We are told that 
the camels attached to the caravans derive from it their chief 
sustenance in many of those desolate regions in which Africa 
abounds.'^ 



Uses.— Gum Arabic dissolved is employed as an article of 
diet in sickness. The mucilage of it is w^ell adapted to cases 
of disease where the stomach and bowels are extremely irrita- 
ble, and where other articles of diet disagree. It is useful as a 
demulcent, as well as affording nourishment in catarrhal affec- 
tions, pleurisy, inflammation of the lungs, and in inflammation 
of the urinary organs. A very good mode of preparing it is to 
dissolve it in composition, pepper or ginger tea. Prepared in 
stimulating tea I have found it to agree well with patients affect- 
ed with diarrhoea and dysentery, and particularly in bowel com-^ 
plaints of infants and children. It is not to be exclusively relied 
upon, however, as a cure in those forms of disease, but to supply 
the system with nourishment, and being combined with a stimu- 
lant, another important object is obtained. It is asserted that 
six ounces of gum Arabic taken daily is sufficient to sustain life 
in a healthy adult. The Moors and Negroes who collect this 
gum, depend almost exclusively upon it for sustenance whilst 
they are engaged in collecting and conveying it to market. 



MATERIA MEDICA. 49!! 



ARROW-ROOT. 



Areow-root is obtained from the root of a plant which is a 
native of South America and of the West Indies. 

The greater part of the article kept in the shops called arrow- 
root, is largely adulterated with potatoe starcii finely prepared. 
It is believed by some, however, that potatoe starch is equal to 
arrow-root in every particular, except that the former is not so 
agreeable to the taste. 

Uses. — Arrows-root is employed as an article of diet in fevers, 
and in bowel complaints of infants and children. 

To make Jirrow-Boot Gruel. — Mix a tablespoonful of the pow- 
der in cold water to the consistence of paste, and then })our this 
gradually into a pint of boiling water, stirring the water as the 
paste is poured in. Sweetened with loaf sugar and a portion of 
lemon juice added, it forms a very agreeable article of diet* 
For infants and ciiiidren arrow-root is usually prepared with 
boiled milk. 

BARLEY WATER. 

To make Barley Wafer. — Take two tablespoonsful of pearl 
barley, wash it in cold w^ater, and then put it into a sauce pan 
adding a quart of cold water, palce it over tlie fire and let it 
boil slowly until the water is reduced nearly one half. Barley 
water may be rendered more palatable by having a small hand- 
ful of stoned raisins or some pieces of liquorice root stewed with 
it. When done it is to be strained. The addition of ginger 
not only improves the taste but affords a mild and pure stimu- 
lant, and promotes digestion. 

Barley is mentioned in the earliest records of history as an 
article of diet in sickness. It is extensively used in cases of 
general fever, and in inflammatory affections, when the condi- 
tion of the stomach will not admit of food, except it be in the 
form of a demulcent. 

To make Milk Porridge. — Take of wheat flour a tablespoonful, 
mix it with cold water to the consistency of paste, pour it into a 
pint and a half of boiling water, and after boiling fifteen or 
twenty minutes; add half a pint of milk. As soon as it be- 
gins to boil, after the milk is added, it will be fit for use. It 
must be salted to suit the taste, and when patients prefer it, loaf 
sugar may be added. 

Milk porridge, properly made, is an agreeable and nourish- 

S M 



498 



MATERIA MEDIC A. 



ing article of diet, and the one mostly taken during and after a 
course of medicine, except in the early stages of violent forms of 
disease, as in violent fever, inflammation of the lungs, &c. 

In giving milk porridge to patients, a small portion of cayenne 
should he added, except in cases of children who refuse to take 
it with pepper in. In making milk porridge for children, a piece 
of ginger root hruised may he added to the water hefore the 
gruel is made. 

In ordinary colds and in disease of a mild character, when 
the digestive powers are not very much prostrated, milk por- 
ridge may be used at any stage of the complaint. 

To make Oat Meal Gruel, — Take of coarsely ground oat meal 
three tablespoonsful, and put it in a pint of hoiling water; let it 
boil gently half an hour, stirring it occasionally. Then strain 
and add a little nutmeg, wine and butter. 

When the oat meal is finely ground, it should be sifted and 
mixed with cold water to the consistence of batter, and then 
poured into boiling water, allowing it to boil gently, and to be 
stirred frequently. 

To ohtain the Essence of Beef or Beef Tea.— Take from one to 
two pounds of fresh lean beef, cut it into small pieces, sprinkle 
it with a little salt and put it into a dry and perfectly clean por- 
ter bottle, or into a glass or stone jar, and cork it moderately 
tight. Set the bottle or jar into a kettle of water, and boil the 
water an hour or more, and then remove it before the bottle is 
taken out, it may otherwise be broken by the sudden change of 
temperature. Essence of beef is highly nutritious and very easy 
of digestion, and consequently forms an important article of diet 
in disease attended with extreme debility, as in the advanced 
stages of fevers, pleurisy, small-pox, dysentery, &c. 

Chicken tea may be made in the same manner as above des- 
cribed, and employed for the same purposes. 

To make Crust Coffee, — Take some of the crust and thin slices 
of stale wheaten bread, toast it thoroughly, so that there shall 
be no part of it unbrowned; pound it and pour on boiling water, 
and after steeping ten or fifteen minutes strain, and it is ready 
for use. It may be sweetened and a portion of milk or cream 
added if the patient ))refer it so. Crust coffee is nourishing and 
generally agrees well with the sick. 

To make Panada* — Take some slices of stale wheaten bread, 
pare off the crusts, and boil them in water four or five minutes, 
then take out the bread, and^^ little of the water it was boiled h\ 



MATERIA MEDICA. 499 

beat it fine, and add sugar and nutmeg, and if proper a little 
fresh butter and some wine. 

To make Mutton BrotL' — Take two pounds of the lean part of 
mutton, and boil it slowly two or three hours in two quarts of 
water, adding a proper quantity of salt and some parsley. The 
fat must be skimmed off. 

Chicken broth may be made in the same way. The chicken 
to be cut up before it is boiled. A small portion of rice or pearl 
barley may be boiled in with tlie chicken. 

By cutting mutton in thin slices and pounding it, half an 
hours boiling will be sufficient. 

To make Wine Wheij. — Put a pint of new milk into a sauce 
pan that will hold at least two quarts; set it over the fire and 
when it is in full boiling and raised to the top of the vessel, dash 
in it a large wineglassful of Madeira or Sherry wine; set the 
sauce pan off and do not stir it for four or five minutes; then 
pour the clear whey from the curd, into a bowl and sweeten it 
with loaf sugar. When it is desired to have the whey more 
stimulating use more wine. Good currant wine may be used 
when neither the Madeira or Sherry can be obtained. 

Wine-wiiey contains a large amount of nourishment which is 
readily absorbed without undergoing the usual process of diges- 
tion in the stomach. It operates also as a diffusive stimulant, 
and hence it is an important article in the treatment of typhus 
fever, and in other forms of disease where the vital energies are 
much enfeebled. 

The chief objection to the use of wine- whey is its tendency to 
become acid in the stomach. This, however, may in a great 
ilegree be prevented by adding to each dose of the whey from five 
to ten grains of the carbonate of ammonia. 

EGG TEA 

Beat up the yolk of a fresh ^^^ and pour on half a pint of 
water. A little wine, salt, and sugar may be added. This is 
liighly nutritious and generally sets easy on the stomach. 

Another Method. — Take the yolk of a hard boiled q^^ mash it 
in a bowl with a silver spoon; then add sufficient of boiling water 
to make it thin enough to be drank. It may be seasoned to 
suit the taste of the patient. 



Drying Roots and Serbs. — The more speedily roots, barks and 
herbs are dried after being collected, the better will their medi- 
cal properties be retained. 



500 



MATERIA MEDICA. 



Bayberry root bark, white pond lily root and other astrin- 
gent articles, may be dried eitlier in the sun or in an oven.— 
White pond lily root cannot be dried properly without either 
being strung on a string and hung up, or placed in an oven. — 
Much of the bayberry root bark in the market has been so long 
in drying that it is often moulded and in a state of decay. Bay- 
berry root bark should be dried in an oven of a moderate heat, 
and then all its medical properties will be retained in a state of 
purity. 

Small fibrous roots such as Virginia snake root, and American 
valerian, may be very readily dried in a warm room or in the 
sun. 



Medical Herbs retain more of their natural flavour and medical 
properties by being dried quickly in an oven at a moderate tem- 
perature soon after they are collected. When thoroughly dried 
they should be pouruled and put into air tight vessels, or packed 
in boxes and secured from the air and from dampness. 

BRIEF REMARKS IN RELATION TO^ CLEANLI- 
NESS, DIET, &c. 

Washing the body in cold water every morning, two or 
three times a week, exhilirates the spirits, promotes digestion? 
strengthens the nerves, and is an almost sure preventive against 
taking cold. 

It is a very bad practice to sleep at night in any of the cloth- 
ing worn through the day. It occasions restlessness, wakeful- 
ness, and terrifying dreams. 

Few persons in the community are aware of the importanceof 
keeping the feet dry. During the seasons of the year that the 
ground is wet and muddy, farmers would find great benefit by 
w^earing wooden soled shoes, as has long been the practice in 
England. 

Walking early in the morning before breakfast agrees with 
many, but with dyspeptics in general it tends to impair rather 
than to strengthen digestion. 

Persons of weak digestion should use moderate exercise in the 
open air soon after meals. This will promote digestion better 
than taking rest. Severe mental or physical labour immediately 
after meals weakens digestion. 

' Eating between locals is a very iHijorioiJS practice, unless the 
food taken be easy of digestion, soch as milk porridge^ gruel, &c. 
Allowing children to eat gir?gcr cakes, mint sticks, and other 
sweet meats between meals, destroys their natural appetite, make 
them feel disti^essed, and consequently they are cross and fretful, 
and when the regular meal time comes they have no appetite, but 



MATERIA MEDICA. 501 

become hungry before the next meal time; and in this way the 
stomach is harassed with such (bod as a child ought never be 
aUowed to eat. When food is given a chihi between meals it 
sliould be good bread and butter, boiled milk, milk porridge, egg 
custard, or some kind of gruel. If a pei'son liaving a weak di- 
gestion eat an apple or piece of pie, or sweet cake, an iiour or half 
an hour before dinner, it will, nine times out often, destroy his 
appetite for dinner. The sick however, often require food in small 
quantities and frequently repeated, more especially in recovering 
from sickness. Under these circumstances it mny be given in 
this way, but it should consist of such articles as are easily di- 
gested. 

Persons of weak digestion sliould take food as warm as they 
can eat it. The assertion that food, with the exception of bread, 
is more wholesome when cold than when warm, is contradicted 
by observation. 

The opinion that vegetable is more easy of digestion, and bet- 
ter suited to the huinan constitution tiian animal food, is not cor- 
rect. There are some individuals of a ])eculiar organization, 
who may feel better by using an exclusively vegetable diet, but 
with the great mass of mankind, a diet of animal and vegetable 
food, combined, is more conducive to health and strength than a 
diet restricted to vegetables. Beef and mutton, either roasted 
or broiled, is less difficult of digestion than vegetable food in 
general. Veal and fresh pork are hard to digest, more paiticu- 
larly is veal unwholesome when the calf has been kept bleeding 
slowly two or tlu'ee days in succession, in order to make the meat 
look white and delicate. By this abominable practice, the ani- 
mal is made sick, and consequently the meat diseased. 

Poultry, salt pork boiled, turtles, fresh fish, eggs, and all 
kinds of wild game, are more easy of digestion than vegetable 
food. I have known dys])eptics who found no kind of food to 
suit them as well as a tender beef steak, broiled, and eaten with 
stale wheaten bread and butter. When the liver is torpid, and 
but little bile secreted, fat meat of ev&i'y description is unwhole- 
some, but when the liver secretes healthy bile, fat meat is easily 
digested and is very nutritious. 

A great portion of the fresh fish brought to our market are 
kept too long to be entirely wholesome. 

The j)ractice of taking any kind of spirituous liquors upon an 
empty stomach, has a tendency to break down the constitu- 
tion, causing a state of both physical and mental depression. A 
good constitution may bear it for awhile, but if the practice be 
continued, the digestive functions will sooner or later become 
impaired under its deleterious influence. 

Persons when riding in cold weather require double the cloth- 
ing needed when they are about their accustomed avocations. 



§02 



POISONS. 



And again, some persons require double the clothing that others 
need to keep them warm, Thus a man of a robust constitution 
and in vigorous health, may bear an exposure to cold with im- 
punity, when one in feeble health would become frozen. 



poisojys. 



MEANS OF COUNTERACTING THE EFFECTS OF 
CONCE^TRxlTED ACIDS. 

When through mistake, or otherwise, sulphuric, muriatic, or 
nitric acid, in an undiluted state is taken into the stomach, the 
best remedy is calcined magnesia, which being an alkali neu- 
tralizes acid and renders it comparatively harmless in the sto- 
mach. If magnesia be not at hand, prepared chalk or common 
chalk may be taken freely, or drink freely of strong soap suds. 

As soon as means are taken to neutralize the acid, green or 
brown lobelia powdered should be given in large doses, in order 
to ensure free vomiting. It may be very difficult to produce 
vomiting before the acid is neutralized. Alkaline injections 
should be administered, followed by an injection containing a 
portion of lobelia. 

Means of comiteracting the effects of Concentrated Alkalies^ such 
as Caustic Potash, Caustic Soda, pure Volatile Mkali, and 
^uick Lime* 

When any concentrated alkali is taken into the stomach, the 
means to be employed to prevent fatal effects is the free use of 
vinegar or of lemon juice. Two tablespoonsful or more of vin- 
egar or lemon juice should be added to a glass of water, and the 
patient continue to drink it freely; and as soon as possible give 
an emetic of lobelia. In all difficult cases, steaming is highly 
important. 

CORROSIVE SUBLIMATE. 



This preparation of mercury is a deadly poison, from one to 
three grains taken into the stomach is sufficient to produce 
death. 

This poison is decomposed and rendered inert by mixing it 
with the whites of eggs* "^Vhen corrosive sublimate has been 



POISONS. 503 

taken into the stomach, the whites of eggs heaten up in a little 
water should he given as soon as possible, even to the amount 
of a dozen eggs or more, and commence at the same time taking 
freely of lobelia, either the powder in warm water, or in the form 
of the tincture, or third preparation. If eggs are not at hand, 
let the patient drink largely of milk in the place of the eggs. 
No time should be lost to have something upon the stomacli and 
to excite vomiting, and whilst other remedies are in preparation 
the patient should drink warm water, and endeavour to excite 
vomiting hy putting a finger or a feather in his throat. When 
the system is poisoned by the external application of corrosive 
sublimate, the same course of treatment will be required as above 
described. 

ARSENIC. 

When arsenic has heen swallowed, vomiting should be ef- 
fected as soon as possible. The best ])lan of treatment is to mix 
lobelia in any form in warm water sweetened, and give it freely, 
Lime water may also he given if at hand. A piece of slackened 
lime thrown into some warm or cold water, will form lime water 
in a few minutes. It sliould be strained through linen or mus- 
lin, as there will not he time to allow it to settle. After free 
vomiting is produced the patient should be steamed, kept warm, 
and take freely of pure stimulants, as pepper, ginger or compo- 
sition tea, and occasionally a dose of lime water. 

A large dose of arsenic will in general cause vomiting, and 
therefore is not so dangerous as a smaller one. A large dose of 
this poison taken into the stomach and not shortly thrown off by 
vomiting, will destroy life in a few hours. 

I recently witnessed a most distressing case of the effects of 
arsenic, a large dose of which had been taken for the purpose of 
self destruction. The poison occasioning vomiting the principle 
part was thrown up; yet a sufficient quantity still remained 
in the stomach to occasion the most disastrous consequenees. — 
The constitution established an inflammatory action in the sto- 
mach to overcome the effects of the poison, but the attending 
physician instead of aiding this restorative action prescribed se- 
datives, such as were calculated to frustrate natures' efforts. — 
At the time that I saw this patient she was taking a preparation 
of morphine, and small doses of nitre. Nature at this time had 
been struggling six w^eeks to overcome the effects of the poison. 
The patient was suffering from extreme racking pains through 
all her limbs and yet had lost the power of moving them, which 
with the distress in her stomach and frequent long continued 
efforts to vomit, together with the remorse felt for having 
made this rash attempt at self destruction presented the most 



504 



POISONS. 



distressing spectacle I ever witnessed. The inflammatory action 
established was the only means by which the constitution could 
recover from the deadening effects of the arsenic, and this effort 
should have been aided by employing the vapour bath, and pure 
stimulants internally to support the secretions and promote the 
natural warmth of the system. Physicians of the old school may 
say tliat such treatment would aggravate the inflammation al- 
ready existing in the stomach. Tiiey are taught to believe that it 
would, but it remains with them to prove it. I know experiment- 
ally that such a course of treatment would have no other effect 
than to aid the sanative efforts of the constitution. 

Arsenic is prescribed both by the Homcepathic and old school 
physicians in Homoepatliic doses as a cure for intermitting fever 
and various other complaints; an unreasonable and injurious 
practice whicli ought never to have been introduced; for it only 
removes one form of disease by estabiisliing another. And the 
long continued and distressing dyspepsia which almost always 
follows tlie use of arsenic is in nine cases out of ten more dis- 
tressing and harder to cure tlian the original disorder would 
have been for which the arsenic was prescribed. The best plan 
of treatment that I have found in cases of dyspepsia occasioned 
by the use of Fowlei'Vs s;)hitian and other preparations of arsenic 
is an orrasional course of medicine, and a free use of cayenne 
pepper with food, or taken siiortiy after meals. 



ANTIMONY. 



Many patients have been greatly injured, and not a few lives 
destroyed by the use of tartarized anliujony commonly called 
tartar emetic. This and the otlier preparations of antimony oc- 
casion vomiting uj)on the same principle that arsenic causes 
it. Tui-tar emetic vJien taken in ordinary emetic doses, 
if it do not cause vomiting it is ajjt to ])roduce active purg- 
ing attended by severely grij)ing ])ain. followed by general pros- 
tration of the digestive ])Oweis, and loss of tone in the bowels. 
The best antidote for the antimonial preparations is lobelia given 
in bayberry, sumac, or raspberry leaf tea; or, it may be taken 
in strong table tea. After i'vei'. vomiting is produced the patient 
should continue to drink strong table tea, and stimulants. If 
the patient be cold and chilled, a vapour bat!» must be adminis- 
tered to aid the operation of the medicine, and tothi'ow the poison 
out of the blood ])rovided any should have been absorbed. In 
cases when the vital powers are greatly ])rostrated by the poison 
the liquid of the third preparation of lobelia should be given as 
an emetic administered in strong bayberry or table t(a, or by 
injection. 



POISONS. 505 

LUNAR CAUSTIC— NITRATE OF SILVER. 

The best antidote for lunar caustic when swallowed, is com- 
mon salt dissolved in water. This should be swallowed freely 
and an emetic of lobelia given. 

NITRE— SALTPETRE. 

Nitre so much employed in the regular practice is <* observes 
Orfila," venemous both to man and to animals, even where ap- 
plied to w^ounds. 

The direct effect of nitre upon the system when taken inter- 
nally is to weaken and destroy vital power. Hence it is called 
a sedative, and medical men governed in their practice by a 
false theory of treating disease employ this article in fever with 
a view to lessen arterial excitement. The necessary result of 
such treatment is to weaken the restorative actions — to saddle 
nature with a greater burden and at the same time cripple her 
energies. 

Nitre has sometimes been taken in doses of from half an ounce 
to an ounce, in mistake for Epsom salts. Taken in this quan- 
tity it is apt to cause violent vomiting, pu-rging of blood, convul- 
sions and sometimes death. 

TREATMENT. 

When a large dose of nitre has been swallowed the patient 
should drink largely of mucilaginous drinks, as flaxseed tea, or 
mucilage of slippery elm, and take freely of lobelia until copious 
vomiting be produced. If the system be in a cold and torpid 
condition the vapour bath must be employed, and a moderate and 
continued warmth applied to the patient in bed, and he should 
take freely of pure stimulants. 

Dr. Samuel Thomson w^as the first one to call the attention of 
the community to the worse than useless practice of employing 
saltpetre in curing meat. It hardens the fibres of meat, and 
renders it more difficult of digestion. 

Poisoning from the fumes of Lead. — This subject is treated of 
under the head of painters' colic. 

Poisoning from Swamp Sumac^ {Rhus Vernix) and from Poison 
Vine, and Poison Oak. — The poisonous effects of the above named 
articles are usually limited to the surface of the body, and rarely 
or never attend'ed by serious consequences. The best external 
application is tincture of lobelia or salt and vinegar* In severe 

SN 



506 



POISONS. 



cases vapour baths should be administered and an emetic given? 
the patient contisiui ug to take broken doses of lobelia in combi- 
nation with composition, pepper or ginger tea. 

OPIUM. 

Opium for medical purposes is generally taken in the form of 
laudanum. Notwithstanding the poisonous nature of this drug, 
it is one of the general medicines employed in the old school 
practice. It eases pain by occasioning a partial stagnation of 
blood in the brain and in this way blunts the sensibilities- 
smothering disease without removing the cause. 

When an over dose of laudanum has been taken, the patient 
should be made to vomit as speedily as possible. Lobelia in 
any form may be given freely, and the patient should be made 
to drink of bayberry tea or strong coffee, if the patient be in a 
stupour, the liquid of the third preparation should be poured 
down the throat and a tablespoonful of tlie third preparation ad- 
ministered by injection, followed by an injection of brown lobelia 
powder in warm water witli a view to aid the operation of the 
emetic. 

Mothers would be very cautious how they gave laudanum to 
make their children sleep if they were acquainted with the prin- 
ciple of its operation, and were fully sensible of the injurious 
consequences which such a practice is liable to produce, not only 
upon the physical, but also upon tlie mental powers of infants 
and children. 

BELLADONNA, 

{Deadly JsTightshade) 

This povverfully narcotic poison is chiefly found about old 
buildings, and along walls in shady places. The plant grows 
to the height of from two to three feet, and bears a round berry 
which is at iirst green, then red, and iiiially they assume a deep 
purple colour and not very unlike a cherry in ap]) 'arance. — 
Children allured by the inviting appearance of the berries are 
not unfrequently induced to eat them and become poisoned. 

The sympttjms which follow an over dose of the deadly night- 
shade are dryness in the throat, dizziness and a swimming sen- 
sation in the head, partial blindness, and difficulty of swallow- 



The indications of treatment, are to excite free vomiting; and 
to sustain vital action by the use of stimulants. 
Belladonna is employed to a considerable extent by hom(s- 



507* POISONS. 

pathic practitioners, particularly in the treatment of scarlet fe- 
ver. Strong poisons given even in very minute doses may 
change the symptoms of a disease, but instead of aiding the con- 
stitution to cast off disease in the way which nature has provided, 
the recuperative actions of the system are weakened, and the de- 
signs of nature frustrated. 'Tis true that patients recover uDder 
this treatment and probably better tlian under the old school 
practice, but where is the evidence that those patients who get 
well under such treatment would not have recovered even more 
perfectly without the medicine. Nature does a gi'eat deal which 
medicine gets the credit of. 

STRYCHNIA. 

Strychnia is one of the most active poisons employed in the 
old school practice. ^^ With the exception of prussiac acid, it is 
perhaps the most violent poison with which we are acquainted, 
and should therefore be administered with great caution." — Z7. 
S. Dispensatory. 

Administered even in Homcepathic doses it is capable of pro- 
ducing the most distressing symptoms. Professor Chapman of 
the University of Pennsylvania asserted that he had been called 
to two cases of Tetanus produced by strychnia prescribed by a 
Homospathic physician. 

The injurious effects of strychnia are believed to arise from 
the poison being absorbed and carried into the circulation. The 
indications of treatment are to give freely of the third prepara- 
tion of lobelia or other active stimulants and administer the va- 
pour bath, with a view to assist nature to clear the system of the 
poison. 

DATURA STRAMONIUM. 

This plant commonly called Gympscin or Jamestown weed 
grows about hog-pens and in other places where the soil is very 
strong. The leaves and seeds of this weed contain a narcotic 
poisonous principle. Children are sometimes poisoned by eat- 
ing the seeds of this plant. ^^When taken in quantities suffi- 
cient to affect the system moderately, it produces more or less 
cerebral disturbance, indicated by vertigo, head-ache, dimness or 
perversion of vision, and confusion of thouglit, sometimes 
amounting to slight delirium, or a species of intoxication." 

The treatment should consist of emetics, and injections follow- 
ed by the use of composition and other stimulating teas, and 
when the heat of the system is far reduced the vapour b^th will 
prove beneficial. 



ERRATA. 



Page 24, ninth line from the bottom, instead of <* the vital powers 

are the causes of disease," read the vital powers and, the cause 

of disease. 
113, for '' Jlpthous sore mouthy'' read *^ Aphthous^" &c. 
133, second paragraph under the head of vapour bath, for, 

^^when the vapour bath" read after the vapour bath. 
154, eighth line from the bottom for ** evacuating^' read expell- 

ing. 
160, Chapter IV. should be VI. 
S30, Chapter XYI. should be XVII. 
193, third line from the bottom for ** enemas^' read means. 
211, eighteenth line from the top for ^'cavities*' read coating, 
182, sixth line from the bottom, for ^* arrives at its course," read 

terminates its course. 
265, second paragraph fifth line for " whef read wet. 
424, eighth line for '^destended its functions" read disttirbed its 

functions. 
492, under the head of Cough Powder, 1st line, for *< livm^worV* 

read liquorice root. 
537, seventeenth line, *< where existence^' read where life. 
489, sixteenth line, for ^^formaed*' read wadfc. 



ZWDS^. 




Abscess in female breast 


365 


Belladonna 


506 


Apoplexy 


203 


Balmony 


464 


Ague and fever 


17 


Barberry 


ib. 


Amber, oil of 


479 


Bonesett 


467 


Anti-acids 


487 


Bitter Almonds 


471 


Aphthous sore mouth 


113 


Bitters, spice 


472 


Antimony- 


504 


Balsam Copaiva 


480 


Asthma 


92 


Balsam Tola 


481 


Arsenic 


503 


Balsam Fir 


ib. 


Anise seed oil 


480 


Barley Water 


497 


Acids 


486 


Bi-carbonate of soda 


487 


Alkalies 


487 


Burdock 


482 


Astringents 


456 


Black Aspen Poplar 


464 


Aspen poplar 


464 


Basilicon Ointment 


493 


American Valerian 


473 


Beef, essence of 


498 


Ammonia liniment 


493 


Beef tea 


ib. 


Astringent ointment 


494 


Brief remarks in relation to 


Arrow-root 


497 


cleanliness, diet, &c. 


500 


Bath, steam or vapour 


415 


Causes of disease in general 7 


Bath, hot air 


422 


Congestive fever 


31 


Blood-letting 


412 


Cow-pox 


49 


Bilious fever 


31 


Chicken-pox 


55 


Bilious colic 


126 


Chafing in children 


78 


Bronchitis 


79 


Consumption 


85 


Bladder, inflammation of 


178 


Catarrh or summer cold 


96 


Bite of a mad dog 


244 


Common cold 


102 


Blindness 


284 


Croup 


105 


Bleeding from the lungs 


317 


Common sore throat 


112 


Bleeding from the nose 


320 


Colic 


115 


Bleeding from wounds 


322 


bilious 


126 


Bruises 


342 


Cholera Morbus 


117 


Burns and scalds 


356 


Infantum 


119 


Biles 


363 


Colica Pittonum 


128 


Bubo 


387 


Constipation 


140 


Bee-stings 


393 


Costiveness 


ib. 


Bowel, protrusion of 


396 


Chronic disease of the liver 196 


Bayberry 


457 


Convulsion Fits 


214 


Beach-drop 


461 


Convulsions of Infants 


218 


Bitters 


ih. 


Chlorosis 


220 



510 


lADEX. 




Craziness from drink 


295 


Diabetes 


182 


Compound Lobelia Pills 


449 


Disease of the liver . 


194-6 


Capsicum 


450 


Dropsy 


252 


Cayenne Pepper 


ih. 


Drowning 


270 


Composition powder 


454 


Delirium tremens 


295 


Crow-foot 


461 


Deafness 


310 


Cranes-bill 


ih 


Disease of Use heart 


313 


Chelone Glabra . 


464 


Disease of the hip 


368 


Centuary 


465 


Detergents 


456 


Columba 


467 


Dewberry root 


460 


Chamomile 


ib. 


Drying roots and herbs 


499 


Conserve of Hollyhock 


472 


Datura stramonium 


507 


Cypripedium 


473 


Deadly nightshade 


506 


Carbonate of Ammonia 


477 






Camphor 


ib. 


Erysipelas 


67 


Cherry stones 


471 


Elongated uvula 


114 


Caraway 


480 


Excessive flow of urine 


182 


Copaiva, balsam 


ib. 


Epilepsy ■ 


214 


Cinchona 


462 


Eyes, inflammation of, from 


Cleavers 


482 


cold 


274 


Caustic potash 


505 


rheumatic inflammation 


Canada balsam 


481 


of 


Q76 


Charcoal 


488 


suppurative inflammation 


Cathartics 


431 


of 


Q77 


Canker 


411 


scrofulous sore 


280 


Course of medicine 


401 


Ear-ache 


307 


Cramp in the legs and feet 


396 


Epistaxis 


320 


Chancre 


384 


Emetics, utility of, in curing 


Carbuncle 


364 


disease 


423 


Corrosive Sublimate 


502 


various methods of prepar- 


Chilblains 


360 


ing 


403 


Crust coffee 


498 


Enemata 


436 


Cancer 


325 


Evan root 


460 


Chalk, prepared 


490 


Eupatorium perfoliatum 


467 


Cough mixtures 


491 


Erigeron Philadelphicum 


482 


Cough powder 


492 


canadense 


482 


Camphor liniment 


493 


Elixir of vitriol 


487 


Cayenne poultice 


495 


Elm 


485 


Catnip poultice 


ib. 


Essence of beef 


498 


Charcoal poultice 


ib. 


Egg tea 


499 


Chicken tea 


498 










Fever and reaction 


9 


Disease defined 


7 


intermitting 


17 


general cause of 


Ib. 


remitting 


. 23 


Dysentery 


131 


bilious 


ib. 


Diarrho&a 


135 


typhus 


31 


Dyspepsia 


143 


congestive 


ib. 



Fever, yellow 
Falling of the palate 
Failing sickness 
Fainting 

Fistula iaclirymalis 
Felon 

Fluor alb us 
Fits, convulsion 

hysteric 
Frozen limbs 
False membrane, coating the 

stomach and bowels in 

disease 
Fir, balsam 



IXDEX. 


5U 

330 r 


ih 


Inflammation, its use, &c. 


114 


of the kidneys 


ir4 ! 


214 


of the peritoneum i 


229 




137 1 


286 


of the bladder 


178 1 


366 


of the liver 


194 i 


392 


of the eyes from 


214 


cold 


274 


224 


Indigestion 


143 


361 


Insanity 


288 


e 


partial 


291 


1 


general 


290 


-411 


Injections, practical application 


481 


of 


436 



Green sickness 
Goitre 
Gonorrhoea 
Gout 
Ginger 
Golden seal 
Guiacum wood 
Granville's lotion 
Gum Arabic 

Health defined 

Hives 

Hysteria 

Hypochondriasis 

Head-ache 

Hydrophobia 

Heart, palpitation of 

disease of 
Hip disease 
Hernia 

strangulated 
Hay-fever 

Hu mam all's Virginian a 
Helonias dioicia 
Hollyhock, conserve 
Hops 
Hickory ashes 

Intermitting fever 

Itch 

Infantile cholera 

Infants sore mouth 



220| 
267 
380 
169 
455 
465 
484 
492 
496 

7 
66 
224 
230 
301 
244 
311 
313 
368 
397 
398 
95 
459 
471 
472 
474 
488 

17 

76 

119 

113 



jjaundice 200 

Joints, wounds of 355 

Kine-pox 49 

Liniment, stimulating 490 

volatile 492 

ammonia 493 

camphor ib. 

soap ib» 

Lotions, volatile 492 

Lunar Caustic 505 

Lime water 489 

Lemon juice 486 

Lady-slipper 483 

Ladies' Spice Bitters 472 

Liriodendron Tulipifera 467 

Lumbago 169 

Lead colic 128 

Liver, inflammation of 194 

chronic disease of 196 

Locked-jaw 240 

Lightning 270 

Lacerated wounds 352 

Lobelia Inflata 443 

preparations of 446 

thii'd preparation of 448 

pills of 449 

Measles 56 

Mumps 111 

Mania 290 

Mad Dog, bite of 244 



513 


INI 


)EX. 




Mania a potu 


295 


Piles 


155 


Menstruation, obstruction of 390 


Paralysis 


207 


Myrica Cirifera 


457 


Palsy 


ib. 


Marsh Rosemary 


460 


Palpitation of the heart 


311 


Myrrh 


467 


Punctured wounds 


353 


pills of 


468 


Protrusion of the bowels 


396 


infusion of 


ib. 


Prolapsus-ani 


ib. 


powdered 


lb. 


Polypus of the nose 


395 


tincture of 


ib. 


Prickly heat 


78 


Mixtures for cough 


491 


Preparation of lobelia 


446 


Mustard plaster 


494 


Pills of lobelia and cayenne 449 


Mallows poultice 


495 


Pills of myrrh 


467 


Myrrh poultice 


496 


Peruvian bark 


462 


Mutton broth 


499 


Poplar, white and black 


Millt porridge 


497 


aspen 


464 


Nitrate of silver 


505 


tulip 


468 


Nettle rash 


66 


Peppermint oil 


480 


Neuralgia 


248 


Prunus Virginiana 


466 


Nervousness 


394 


Peach meats 


461 


Nymphia Odorata 


459 


Poisons 


502 


No. 3 


456 


Poisoning from nitric acid 


ib. 


No. 6 


469 


sulphuric 


ib. 


No. 5 


470 


muriatic 


ib. 


Nitre 


505 


caustic potash 


ib. 


Nervines 


473 


caustic soda 


ib. 


No. 3 pills 


491 


volatile alkali 


ib. 


Nightshade 


506 


quick lime 


ib. 






corrosive sublimate 


ib. 


Organic disease of the heart 313 


arsenic 


503 


Obstructed menstruation 


390 


antimony 


504 


Oil of turpentine 


478 


lunar caustic 


505 


Oil of amber 


479 


nitrate of silver 


ib. 


Oil of horsemint 


ib. 


nitre or saltpetre 


ib. 


Oil of peppermint 


480 


fumes of lead 


ib. 


Oil of anise seed 


ib. 


swamp sumac 


ib. 


Oil of caraway 


ib. 


poison vine 


ib. 


Ointment, Basilicon 


493 


opium 


506 


astringent 


494 


belladonna 


ib. 


pile 


ib. 


deadly nightshade 


ib. 


Oat Meal Gruel 


498 


strychnia 


507 


Opium 


506 


datura stramonium 


ib. 






Jamestown weed 


ib. 


Pulmonary consumption 


85 


gy mpson weed 


ib. 


Phthisic 


92 


Pipsissewa 


482 


Pleurisy 


99 


Prickly ash 


483 


Painters Colic 


128 


Pyrola umbellata 


482 


Peritonitis 


137 


Prepared charcoal 


488 





INDEX, 


513 


Prepared chalk 


490 


Summer catarrh 


96 


ritcli plaster 


494 


Summer cold 


ib. 


Plaster, Thomson's 


stren2;th- 


Sore moutli 


112 


ening 


ih. 


Stranguary 


188 


Poultice, cayenne 


495 


Suppression of ui-ine 


192 


Thomson's 


ib. 


St. Vitus' dance 


QS5 


catnip 


ib. 


Scrofula 


262 


Mallow's 


ib. 


Suspended animation fron? 




charcoal 


ib. 


drowning 


270 


yeast 


496 


from carhonic aci 


d 


myrrh 


ib. 


gas 


271 


Panada 


498 


from lightning 


273 






Suppurative sore eyes 


277 


Quinsy 


109 


Scrofulous sore eyes 


280 


Quinine 


463 


Stye on the eye-lid 


285 


Quassia 


466 


Sick head-ache 


301 



Reaction and fever 9 

Remitting fever 31 

Ring-worm 77 

Rheumatism 160 
in the loiiis 169 

Rheumatic drops 469 

Relax 135 

Retention of urine 184 
Rheumatic inflammation of 

the eyes 276 

Running of the ears 308 

Rupture 397 

Rubus strigosis 459 

Raspberry leaves ib. 

Rubus procumbens 460 

Red willow ib. 

Restorative cordial 470 

Rose 67 

Saltpetre 505 

Stramonium 507 

Strychnia ib. 

Strengthening plaster 494 

Simple cerate 493 

Soap liniment ib. 

Stimulating liniment 490 

Small pox 41 

Scarlet fever 59 

Shingles 70 

Scald head 72 



Structui'al disease of the 

heart 313 

Sprains 340 

Severe bruises 342 

Scalp, wounds of 346 

Simple ulcers 375 

Swelled breast * 365 

Swelling in the groin 387 

Stimulants 450 

Sumac 458 

Serpentaria Virginiana 465 

Spice bitters 472 

Scull-cap 473 

Scabious 482 

Sarsaparilla 483 

decoction of 484 

beer ib. 

compound decoction 

of ib, 

syrup of ib. 

Slippery elm 485 

Sup. carbonate of soda 487 

Salseratus ib. 

Strangulated hernia 398 



Typhus fever 

Tetter 

Tooth -ache 

Tetanus 

Ticdouloureux 

Treatment of frozen limbs 361 





31 

73 
305 
240 
248 



514 


IJ^DEX. 




Thomsonian Materia Medi 


. 


Vapour bath 


415 


ca 


443 


Virginia snake root 


465 


Third preparation of lobelia 448 


Valerian 


473 


Tincture of lobelia 


446 


Vegetable balsams 


480 


Tulip poplar 


467 


Vinegar 


486 


I'horoughwort 


ib. 


Volatile liniments 


492 


Tincture of myrrh 


468 






Thon)son's No. 6 


469 


Whooping cough 


97 


Turpentine, oil of 


478 


Wounds of the scalp 


346 


Tolu balsam 


481 


by sharp instruments 


; 350 


Thomson's salve 


493 


lacerated 


352 


strengthening plaster 


494 


bruised 


353 






punctured 


ib. 


Uvula elongated 


114 


of joints 


355 


Urine, excessive flow of 


182 


Whitlow 


366 


retention of 


184 


White swelling 


372 


difficulty in voiding 


188 


Weak nerves 


394 


involuntary flow of 


190 


Worms 


151 


suppression of 


192 


White pond-lily 


459 


Ulcers 


374 


Wild raspberry leaves 


ib. 


healthy 


375 


Witch hazie 


ib. 


unhealthy 


ib. 


White aspen poplar 


464 


Upland sumac 


458 


Worm wood 


485 


Unicorn 


471 


Wine whey 


499 


Ulmus fulva 


485 










Yellow fever 


31 


Vaccination 


49 


Yeast poultice 


496 


Varioloid 


53 






Varicella 


55 






Venereal 


380 


Zanthoxylum fraxineum 


483 



PIllLADELPniA 

THOMSONIAN MEDICINE STORE, 



The proprietor of this establishment has cotistuntly on hand 
a general assortment of Thomsonian medicines, which will be 
soh! in quantities to suit purchasers. 

Tlie compounds are prepared of the very best articles, and 
neatly put up with directions for using. 

Especial care is taken that each article is collected in the 
proper season, in order that it may contain all its medicinal 
properties. 

Also for sale the most approved syringes, and every other 
article in his line of business. All of which will be sold low for 
cash. 

Orders from any part of the Union attended to. 

AARON COMFOKT. 



nm 




'l^lft^ii!f!t^'^\J^fm^ajtmauem 



